DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Shields, Ann Marie	DOIID	1021717	NAIC NPN	18977726

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	12/13/2018		2/28/2025
Active	Non Resident	Agent	Life	12/13/2018		2/28/2025
* 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	12/15/2024	02/28/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American General Life Insurance Company	301585	Agent - Health	12/26/2018	1/14/2022
Inactive	American General Life Insurance Company	301585	Agent - Life	12/26/2018	1/14/2022
Active	Anthem Life Insurance Company	301209	Agent - Health	2/13/2020
Active	Anthem Life Insurance Company	301209	Agent - Life	2/13/2020
Inactive	Aspen American Insurance Company	301513	Agent - Health	7/17/2020	12/14/2020
Active	CareSource Kentucky Co.	838179	Agent - Health	10/20/2021
Active	Golden Rule Insurance Company	301943	Agent - Health	6/21/2019
Active	Golden Rule Insurance Company	301943	Agent - Life	6/21/2019
Inactive	LifeShield National Insurance Company	737111	Agent - Health	3/19/2019	12/21/2021
Active	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	11/4/2021
Inactive	Pan-American Life Insurance Company	301530	Agent - Health	5/3/2021	5/26/2023
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	2/18/2019	11/18/2020
Inactive	United States Fire Insurance Company	582240	Agent - Health	7/20/2021	3/15/2022
Active	WellCare Health Plans of Kentucky, Inc.	838592	Agent - Health	10/15/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Designated Agent Company Inc.	681257	Agent - Health	2/13/2020
Active	Designated Agent Company Inc.	681257	Agent - Life	2/13/2020
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	4/16/2019	4/28/2022