DEPARTMENT OF INSURANCE

Affiliations

Name	Patrick Graham, La Chanette De Shun	DOIID	1263743	NAIC NPN	17332238

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Health	6/8/2023	6/30/2024
Pending Replacement	Non Resident	Agent	Life	6/8/2023	6/30/2024
Pending Replacement	Non Resident	Staff Adjuster	Property & Casualty	3/22/2023	6/30/2024
* 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	04/15/2024	06/30/2024
Staff Adjuster	04/15/2024	06/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	7/14/2023	11/17/2023
Pending Replacement	Aetna Health Inc. (PA)	660717	Agent - Health	6/12/2023
Pending Replacement	Aetna Health of Ohio Inc.	1065035	Agent - Health	6/12/2023
Pending Replacement	Aetna Life Insurance Company	301140	Agent - Health	6/12/2023
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	9/27/2023	3/14/2024
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/27/2023	3/14/2024
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/27/2023	3/14/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/27/2023	3/14/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/27/2023	3/14/2024
Pending Replacement	CIGNA Health & Life Insurance Company	301783	Agent - Health	7/28/2023
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	9/17/2023	11/29/2023
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	9/13/2023	12/11/2023
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	9/13/2023	12/11/2023
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/27/2023	3/14/2024
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	7/14/2023	5/7/2024
Pending Replacement	Guardian Life Insurance Company of America	301316	Agent - Health	8/7/2023
Pending Replacement	Guardian Life Insurance Company of America	301316	Agent - Life	8/7/2023
Inactive	Monitor Life Insurance Company of New York	1117550	Agent - Health	8/19/2023	12/1/2023
Inactive	Monitor Life Insurance Company of New York	1117550	Agent - Life	8/19/2023	12/1/2023
Pending Replacement	SilverScript Insurance Company	663526	Agent - Health	6/12/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/17/2023	11/29/2023
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/17/2023	11/29/2023
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	6/13/2023	12/27/2023
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	6/13/2023	12/27/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Extend Insurance Services, LLC	625753	Agent - Life	8/7/2023	2/1/2024
Inactive	Extend Insurance Services, LLC	625753	Agent - Health	8/3/2023	2/1/2024