DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Kubik, Jeffery J	DOIID	321007	NAIC NPN	528401

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	6/24/1997		10/31/2026
Active	Non Resident	Agent	Health	6/24/1997		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
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/17/2012	3/14/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Health	7/18/2012	6/26/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	7/18/2012	6/26/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/22/2021	12/12/2024
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	1/22/2013	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/22/2021	12/12/2024
Inactive	Humana Insurance Company	301104	Agent - Health	3/22/2021	12/12/2024
Inactive	Humana Insurance Company	301104	Agent - Life	7/17/2012	12/19/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/22/2021	12/12/2024
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/22/2021	12/12/2024
Inactive	HumanaDental Insurance Company	301457	Agent - Health	7/18/2012	12/19/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	7/18/2012	12/19/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	7/17/2012	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	7/17/2012	10/22/2015
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/24/1997	11/21/2005
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	6/24/1997	11/21/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Employee Benefit/Risk Management Services LLC	1184425	Agent - Life	6/24/2022	12/12/2024
Inactive	Employee Benefit/Risk Management Services LLC	1184425	Agent - Health	6/24/2022	12/12/2024