DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Bontiff, Khori	DOIID	1210894	NAIC NPN	20336301

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	6/14/2022		10/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	08/15/2026	10/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	8/17/2022	8/14/2025
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	8/29/2022	12/12/2024
Inactive	Humana Insurance Company	301104	Agent - Health	8/31/2022	8/14/2025
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/6/2022	12/13/2022
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	9/6/2022	12/12/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	TZ Insurance Solutions LLC	727470	Agent - Health	1/15/2025	2/13/2025
Inactive	Trubridge Inc	717747	Agent - Health	8/14/2023	1/15/2025