DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Randolph, Scott	DOIID	1005760	NAIC NPN	18875708

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	8/18/2018	8/31/2021
Inactive	Non Resident	Agent	Health	8/18/2018	8/31/2021
* 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	Continental American Insurance Company	301700	Agent - Health	9/6/2018	1/6/2021
Inactive	Continental American Insurance Company	301700	Agent - Life	9/6/2018	1/6/2021
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	11/2/2018	10/8/2021
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	11/2/2018	10/8/2021
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	11/2/2018	10/8/2021
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	11/2/2018	10/8/2021
Inactive	Unum Insurance Company	301499	Agent - Health	11/2/2018	10/8/2021
Inactive	Unum Insurance Company	301499	Agent - Life	11/2/2018	10/8/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Health	1/28/2019	8/31/2021
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Life	1/28/2019	8/31/2021