DEPARTMENT OF INSURANCE

Affiliations

Name	Malcolm, Justin Tyler	DOIID	1022065	NAIC NPN	18851823

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	12/13/2018	9/30/2026
Active	Non Resident	Agent	Life	12/13/2018	9/30/2026
* 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	07/15/2024	09/30/2024	09/30/2024	09/30/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AXIS Insurance Company	301290	Agent - Health	3/22/2021	4/6/2023
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	7/19/2019	7/27/2020
Active	American Financial Security Life Insurance Co.	301635	Agent - Health	2/25/2021
Active	American Financial Security Life Insurance Co.	301635	Agent - Life	7/26/2022
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/12/2023
Active	Anthem Life Insurance Company	301209	Agent - Health	10/12/2023
Active	Anthem Life Insurance Company	301209	Agent - Life	10/12/2023
Inactive	Aspen American Insurance Company	301513	Agent - Health	9/28/2020	12/15/2020
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	4/24/2019	7/23/2019
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	4/24/2019	7/23/2019
Inactive	Continental American Insurance Company	301700	Agent - Health	5/1/2019	2/8/2022
Inactive	Continental American Insurance Company	301700	Agent - Life	5/1/2019	2/8/2022
Active	Federal Insurance Company	301144	Agent - Health	4/28/2020
Inactive	Federal Life Insurance Company	300945	Agent - Health	2/7/2023	9/5/2023
Inactive	Gerber Life Insurance Company	300529	Agent - Health	8/6/2021	12/1/2022
Inactive	Gerber Life Insurance Company	300529	Agent - Life	8/6/2021	12/1/2022
Inactive	Golden Rule Insurance Company	301943	Agent - Health	9/23/2019	12/13/2020
Inactive	Golden Rule Insurance Company	301943	Agent - Life	9/23/2019	12/15/2020
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	10/28/2020	12/30/2022
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	10/28/2020	12/30/2022
Active	National Guardian Life Insurance Company	300596	Agent - Health	7/22/2022
Active	National Health Insurance Company	300554	Agent - Health	1/30/2021
Active	National Health Insurance Company	300554	Agent - Life	1/30/2021
Active	North River Insurance Company (The)	301739	Agent - Health	6/27/2023
Inactive	Southern Guaranty Insurance Company	969411	Agent - Health	4/28/2020	7/5/2023
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	11/2/2020	11/13/2023
Active	Unified Life Insurance Company	543169	Agent - Health	11/8/2023
Active	United States Fire Insurance Company	582240	Agent - Health	4/18/2024
Active	WellCare Health Plans of Kentucky, Inc.	838592	Agent - Health	8/9/2024
Active	Wellfleet Insurance Company	300542	Agent - Health	3/19/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	7/11/2019	4/18/2022