DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Musselman, Ammon	DOIID	1052948	NAIC NPN	18926183

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	8/22/2019	11/30/2020
Inactive	Non Resident	Agent	Health	8/22/2019	11/30/2020
* 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	Anthem Life Insurance Company	301209	Agent - Health	10/30/2019	11/30/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/30/2019	11/30/2020
Inactive	Federal Insurance Company	301144	Agent - Health	9/11/2019	11/30/2020
Inactive	Golden Rule Insurance Company	301943	Agent - Health	9/11/2019	12/3/2020
Inactive	Golden Rule Insurance Company	301943	Agent - Life	9/11/2019	12/3/2020

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 - Life	10/30/2019	11/30/2020
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/30/2019	11/30/2020
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	9/11/2019	11/30/2020