DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Rountree, Ann M	DOIID	1062116	NAIC NPN	17867416

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/22/2019	5/21/2021
Inactive	Non Resident	Agent	Life	10/22/2019	5/21/2021
* 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	12/19/2019	5/9/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/19/2019	5/9/2021
Inactive	Independence American Insurance Company	524747	Agent - Health	12/17/2019	12/18/2020
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	12/17/2019	5/21/2021
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/23/2019	5/21/2021

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 - Life	12/19/2019	5/9/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/19/2019	5/11/2021