DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Siepamann Borges Da Silva, Kim	DOIID	1214964	NAIC NPN	20375572

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Health	7/6/2022		6/30/2025
Pending Replacement	Non Resident	Agent	Life	7/6/2022		6/30/2025
* 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	04/15/2025	06/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	8/1/2022	2/1/2023
Inactive	Accendo Insurance Company	300312	Agent - Life	8/1/2022	2/1/2023
Pending Replacement	Aetna Health Inc. (PA)	660717	Agent - Health	7/20/2022
Pending Replacement	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/20/2022
Pending Replacement	Aetna Life Insurance Company	301140	Agent - Health	7/20/2022
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/26/2022	11/10/2022
Pending Replacement	SilverScript Insurance Company	663526	Agent - Health	7/20/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/8/2022	11/10/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	7/8/2022	11/10/2022
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	7/8/2022	11/10/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Smart Match Insurance Agency LLC	829381	Agent - Life	8/1/2022	8/31/2022
Inactive	Smart Match Insurance Agency LLC	829381	Agent - Health	7/28/2022	8/31/2022