DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	National Insurance Associates DBA : EXEMPLAR INSURANCE ASSOCIATES	DOIID	1072755	NAIC NPN	19098696

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	2/2/2020		3/31/2026
Active	Non Resident	Agent	Life	2/2/2020		3/31/2026
* 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
Active	Aetna Health Inc. (PA)	660717	Agent - Health	4/7/2020
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/28/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	4/7/2020
Inactive	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	7/23/2021	6/14/2022
Active	SilverScript Insurance Company	663526	Agent - Health	4/7/2020
Active	Standard Life and Accident Insurance Company	301534	Agent - Health	8/3/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hawley, Tim M	607672	Agent - Health	2/2/2020
Active	Hawley, Tim M	607672	Agent - Life	2/2/2020