DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mbanasor, Peter J	DOIID	1152883	NAIC NPN	20032626

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	10/8/2021		12/31/2026
Active	Resident	Agent	Life	9/8/2021		12/31/2026
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/1/2025
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	5/16/2024	12/16/2024
Active	Anthem Life Insurance Company	301209	Agent - Life	1/1/2025
Inactive	Northwestern Long Term Care Insurance Company	300135	Agent - Health	5/19/2022	12/5/2023
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Health	10/11/2021	12/5/2023
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Life	10/11/2021	12/5/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	The Underwriters Group, Inc	674720	Agent - Life	5/16/2024	12/16/2024
Inactive	The Underwriters Group, Inc	674720	Agent - Health	5/16/2024	12/16/2024