DEPARTMENT OF INSURANCE

Affiliations

Name	Willis, Dean	DOIID	1052742	NAIC NPN	17411352

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/21/2019	1/31/2022
* 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	Accendo Insurance Company	300312	Agent - Health	9/10/2021	1/31/2022
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	10/8/2020	1/31/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	4/30/2020	1/31/2022
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	10/8/2020	1/31/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/8/2020	1/31/2022
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	12/10/2019	4/26/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	12/3/2020	1/31/2022
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Health	5/13/2020	9/1/2020
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	5/27/2020	9/1/2020
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	12/24/2019	8/14/2020
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	4/30/2020	1/31/2022
Inactive	GPM Health and Life Insurance Company	927255	Agent - Health	9/26/2019	3/3/2022
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	11/4/2019	3/3/2022
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/8/2020	1/31/2022
Inactive	United World Life Insurance Company	300532	Agent - Health	11/4/2019	3/3/2022
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	11/4/2019	3/3/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/3/2020	6/4/2021
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/3/2020	6/4/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/3/2020	6/4/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/3/2020	6/4/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/9/2019	4/27/2021
Inactive	Ensurem II LLC	908041	Agent - Health	8/26/2020	6/10/2021