DEPARTMENT OF INSURANCE

Affiliations

Name	Derbyshire, Elena	DOIID	1067506	NAIC NPN	19303836

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	12/6/2019	5/31/2021
Inactive	Non Resident	Agent	Life	12/6/2019	5/31/2021
* 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	Accendo Insurance Company	300312	Agent - Life	1/19/2021	5/31/2021
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	7/16/2020	5/31/2021
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	7/21/2020	5/31/2021
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/12/2020	5/31/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Health	7/16/2020	5/31/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Life	7/16/2020	5/31/2021
Inactive	American Continental Insurance Company	643130	Agent - Life	1/19/2021	5/31/2021
Inactive	American General Life Insurance Company	301585	Agent - Health	1/22/2021	5/31/2021
Inactive	American General Life Insurance Company	301585	Agent - Life	1/22/2021	5/31/2021
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	8/14/2020	5/31/2021
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	7/16/2020	10/30/2020
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	7/21/2020	5/31/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Health	9/30/2020	6/2/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Life	9/30/2020	6/2/2021
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	8/26/2020	5/31/2021
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	8/26/2020	5/31/2021
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	7/22/2020	11/2/2020
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/12/2020	5/31/2021
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/2/2020	7/26/2021
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	11/2/2020	7/26/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	11/2/2020	7/26/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	11/2/2020	7/26/2021
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	8/24/2020	5/31/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	8/24/2020	5/31/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Extend Insurance Services, LLC	625753	Agent - Life	8/3/2020	10/1/2020
Inactive	Extend Insurance Services, LLC	625753	Agent - Health	8/3/2020	10/1/2020