DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	BREEZE FMO LLC	DOIID	1230094	NAIC NPN	20321901

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/16/2022		3/31/2026
Active	Non Resident	Agent	Life	9/16/2022		3/31/2026
Active	Non Resident	Agent	Casualty	9/16/2022		3/31/2026
Active	Non Resident	Agent	Property	9/16/2022		3/31/2026
* 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	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	9/19/2022
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/19/2022
Active	American National Insurance Company	301861	Agent - Life	12/1/2022
Active	CareSource Kentucky Co.	838179	Agent - Health	1/29/2024
Active	National Guardian Life Insurance Company	300596	Agent - Health	9/28/2022
Active	Philadelphia American Life Insurance Company	300178	Agent - Health	12/15/2022
Active	Philadelphia American Life Insurance Company	300178	Agent - Life	12/15/2022
Active	Tier One Insurance Company	301056	Agent - Health	1/3/2023

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Burton, Kevin Eugene	1089770	Agent - Casualty	9/16/2022
Active	Burton, Kevin Eugene	1089770	Agent - Health	9/16/2022
Active	Burton, Kevin Eugene	1089770	Agent - Life	9/16/2022
Active	Burton, Kevin Eugene	1089770	Agent - Property	9/16/2022