DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Matousek, Kerrin T	DOIID	1014465	NAIC NPN	3165544

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	10/10/2018		12/31/2026
Active	Non Resident	Agent	Health	10/10/2018		12/31/2026
* 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
Pending Replacement	Dental Care Plus Inc.	301495	Agent - Health	7/9/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/19/2018	7/30/2021
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	10/19/2018	7/30/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/19/2018	7/30/2021
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	10/19/2018	7/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Of Arizona Inc	511502	Agent - Health	11/6/2018	3/6/2020
Inactive	Willis Of Arizona Inc	511502	Agent - Life	11/6/2018	3/6/2020
Inactive	Willis Towers Watson Insurance Services West Inc	538729	Agent - Health	2/1/2020	8/17/2021
Inactive	Willis Towers Watson Insurance Services West Inc	538729	Agent - Life	2/1/2020	7/30/2021