DEPARTMENT OF INSURANCE

Affiliations

Name	Commission Fund 4 LLC	DOIID	897898	NAIC NPN	17620535

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	11/3/2015	3/31/2027
Active	Non Resident	Agent	Health	11/3/2015	3/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Retirement Life Insurance Company	706303	Agent - Health	1/21/2020	12/22/2020
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Health	9/23/2019	5/23/2023
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Life	9/23/2019	5/23/2023
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	9/23/2019	5/23/2023
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	9/23/2019	5/23/2023
Inactive	Banner Life Insurance Company	301696	Agent - Life	10/17/2018	3/31/2025
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Inactive	Central States Indemnity Company of Omaha	300285	Agent - Health	11/24/2015	8/13/2018
Inactive	Columbian Life Insurance Company	300810	Agent - Life	7/6/2022	7/18/2024
Inactive	Elips Life Insurance Company	301087	Agent - Health	4/14/2022	1/23/2025
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	2/18/2017	2/23/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	2/18/2017	4/20/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	2/18/2017	4/20/2018
Inactive	Lumico Life Insurance Company	300354	Agent - Health	1/19/2020	2/17/2023
Inactive	Medico Corp Life Insurance Company	301777	Agent - Health	8/18/2017	3/14/2018
Inactive	Medico Corp Life Insurance Company	301777	Agent - Life	8/18/2017	3/14/2018
Inactive	Medico Insurance Company	301559	Agent - Health	8/18/2017	12/26/2018
Inactive	Medico Insurance Company	301559	Agent - Life	8/18/2017	12/26/2018
Inactive	Medico Life and Health Insurance Company	907406	Agent - Health	10/8/2018	12/28/2020
Inactive	Medico Life and Health Insurance Company	907406	Agent - Life	10/8/2018	12/28/2020
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	5/21/2020
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	11/14/2016	12/20/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	5/21/2020	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	5/21/2020	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	5/21/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Emerton, David L	319947	Agent - Health	11/3/2015
Active	Emerton, David L	319947	Agent - Life	11/3/2015