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.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	8/17/2022
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	8/29/2022	12/12/2024
Active	Humana Insurance Company	301104	Agent - Health	8/31/2022
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