DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mutual Med Insurance Services LLC	DOIID	1105629	NAIC NPN	13733306

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	10/20/2020		3/31/2026
Active	Non Resident	Agent	Health	10/20/2020		3/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	9/10/2021	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	11/23/2023
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	11/23/2023
Active	All Savers Insurance Company	301940	Agent - Health	10/8/2021
Active	All Savers Insurance Company	301940	Agent - Life	10/8/2021
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022	7/18/2025
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	11/23/2023
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	11/23/2023
Active	Tier One Insurance Company	301056	Agent - Health	4/19/2023
Active	Tier One Insurance Company	301056	Agent - Life	4/19/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/8/2021	7/18/2025
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	10/8/2021
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	10/4/2021	12/22/2022
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	6/1/2023
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/11/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/4/2021	7/18/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bender, Janson J	1105300	Agent - Health	10/20/2020	12/31/2022
Inactive	Bender, Janson J	1105300	Agent - Life	10/20/2020	12/31/2022
Active	Edel, Robert D	1127077	Agent - Health	3/14/2023
Active	Edel, Robert D	1127077	Agent - Life	3/14/2023
Denied	Johnston, Phyllis M	1109541	Agent - Health
Denied	Johnston, Phyllis M	1109541	Agent - Life