DEPARTMENT OF INSURANCE
Affiliations
NameDornbusch, Douglas RogerDOIID324125NAIC NPN1889240
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveResidentAgentCasualty8/15/2000 8/31/2025
ActiveResidentAgentHealth4/18/1989 8/31/2025
ActiveResidentAgentProperty8/15/2000 8/31/2025
ActiveResidentAgentLife4/18/1989 8/31/2025
InactiveResidentAgentHealth Maintenance Organization6/17/19983/1/2001 
InactiveResidentAgentGeneral Lines1/17/19898/15/2000 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent06/15/202508/31/2025   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAegis Security Insurance Company300492Agent - Casualty3/21/201711/7/2022
InactiveAegis Security Insurance Company300492Agent - Property3/21/201711/7/2022
InactiveAetna Health Inc.300694Agent - Health3/13/200112/31/2007
InactiveAetna Health Inc. (PA)660717Agent - Health12/31/20079/22/2010
InactiveAetna Life Insurance Company301140Agent - Health3/13/20019/22/2010
InactiveAetna Life Insurance Company301140Agent - Life3/13/20019/22/2010
InactiveAlea North America Insurance Company301594Agent - Casualty12/27/20003/31/2002
InactiveAlea North America Insurance Company301594Agent - Property12/27/20003/31/2002
InactiveAllianz Life Insurance Company of North America301791Agent - Health5/6/199811/22/2007
InactiveAllianz Life Insurance Company of North America301791Agent - Life5/6/199811/22/2007
InactiveAmTrust Insurance Company300179Agent - General Lines4/13/19892/26/1996
InactiveAmerican Casualty Company of Reading, Pennsylvania300956Agent - Casualty11/6/200212/12/2003
InactiveAmerican Casualty Company of Reading, Pennsylvania300956Agent - General Lines1/17/19898/15/2000
InactiveAmerican Casualty Company of Reading, Pennsylvania300956Agent - Property11/6/200212/12/2003
ActiveAmerican Economy Insurance Company300315Agent - Casualty3/12/2024 
ActiveAmerican Economy Insurance Company300315Agent - Property3/12/2024 
ActiveAmerican Fire and Casualty Company300567Agent - Casualty3/13/2006 
ActiveAmerican Fire and Casualty Company300567Agent - Property3/13/2006 
ActiveAmerican Modern Property and Casualty Insurance Company301954Agent - Casualty7/4/2020 
ActiveAmerican Modern Property and Casualty Insurance Company301954Agent - Property7/4/2020 
InactiveAmerican Reliable Insurance Company301889Agent - Casualty8/16/200612/12/2007
InactiveAmerican Reliable Insurance Company301889Agent - Property8/16/200612/12/2007
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health4/14/2025 
ActiveAnthem Life Insurance Company301209Agent - Health12/21/2017 
ActiveAnthem Life Insurance Company301209Agent - Life12/21/2017 
InactiveAssurance Company of America300432Agent - Casualty8/15/200012/16/2014
InactiveAssurance Company of America300432Agent - General Lines10/20/19898/15/2000
InactiveAssurance Company of America300432Agent - Property8/15/200012/16/2014
ActiveAutomobile Insurance Company of Hartford, Connecticut300630Agent - Casualty2/9/2001 
ActiveAutomobile Insurance Company of Hartford, Connecticut300630Agent - Property2/9/2001 
ActiveBanner Life Insurance Company301696Agent - Life7/29/2003 
ActiveBrighthouse Life Insurance Company301829Agent - Life11/14/2014 
InactiveBuckeye Union Insurance Company (The)300597Agent - General Lines2/5/19973/31/1998
InactiveCHA HMO, Inc.300662Agent - Health3/5/200412/10/2012
InactiveCeltic Insurance Company300877Agent - Health12/14/19933/31/1997
InactiveCeltic Insurance Company300877Agent - Life12/14/19933/31/1997
InactiveCharter Oak Fire Insurance Company (The)301501Agent - Casualty2/9/200112/5/2013
InactiveCharter Oak Fire Insurance Company (The)301501Agent - Property2/9/200112/5/2013
InactiveChase Insurance Life and Annuity Company300518Agent - Health3/5/20014/1/2007
InactiveChase Insurance Life and Annuity Company300518Agent - Life3/5/20014/1/2007
InactiveColumbus Life Insurance Company301227Agent - Life5/17/20171/11/2021
InactiveCommercial Insurance Company of Newark, New Jersey300328Agent - General Lines2/3/19973/31/1998
InactiveCompBenefits Dental, Inc.591692Agent - Health6/27/20087/14/2014
InactiveCompBenefits Insurance Company301864Agent - Health6/27/20087/2/2013
InactiveCompBenefits Insurance Company301864Agent - Life6/27/20087/2/2013
InactiveConseco Insurance Company301202Agent - Life4/15/199810/1/2010
InactiveConseco Medical Insurance Company300719Agent - Health8/17/19934/27/1998
InactiveConseco Medical Insurance Company300719Agent - Life8/17/19934/27/1998
InactiveConsolidated Insurance Company300943Agent - Casualty9/8/20074/26/2024
InactiveConsolidated Insurance Company300943Agent - Property9/8/20074/26/2024
InactiveContinental Casualty Company301019Agent - Casualty11/6/200212/12/2003
InactiveContinental Casualty Company301019Agent - General Lines1/17/19898/15/2000
InactiveContinental Casualty Company301019Agent - Property11/6/200212/12/2003
InactiveContinental Insurance Company (The)301242Agent - Casualty8/15/20009/3/2002
InactiveContinental Insurance Company (The)301242Agent - General Lines2/5/19978/15/2000
InactiveContinental Insurance Company (The)301242Agent - Property8/15/20009/3/2002
Pending ReplacementDental Care Plus Inc.301495Agent - Health4/15/2007 
InactiveDental Concern Inc. (The)301641Agent - Health3/21/20097/14/2014
ActiveErie Family Life Insurance Company301400Agent - Health9/1/2020 
ActiveErie Family Life Insurance Company301400Agent - Life3/1/2018 
ActiveErie Insurance Company300230Agent - Casualty3/1/2018 
ActiveErie Insurance Company300230Agent - Property3/1/2018 
ActiveErie Insurance Company of New York789916Agent - Casualty3/1/2018 
ActiveErie Insurance Company of New York789916Agent - Property3/1/2018 
ActiveErie Insurance Exchange300789Agent - Casualty3/1/2018 
ActiveErie Insurance Exchange300789Agent - Property3/1/2018 
ActiveErie Insurance Property & Casualty Company789942Agent - Casualty3/1/2018 
ActiveErie Insurance Property & Casualty Company789942Agent - Property3/1/2018 
InactiveFalls Lake National Insurance Company301796Agent - General Lines4/25/19966/29/2000
InactiveFarmers Property and Casualty Insurance Company301237Agent - Casualty8/15/20007/12/2001
InactiveFarmers Property and Casualty Insurance Company301237Agent - General Lines8/24/19938/15/2000
InactiveFarmers Property and Casualty Insurance Company301237Agent - Property8/15/20007/12/2001
InactiveFidelity Life Association, A Legal Reserve Life Insurance Company300774Agent - Health3/19/200110/28/2008
InactiveFidelity Life Association, A Legal Reserve Life Insurance Company300774Agent - Life3/19/200111/24/2009
InactiveFidelity and Casualty Company of New York (The)300160Agent - Casualty8/15/20009/3/2002
InactiveFidelity and Casualty Company of New York (The)300160Agent - General Lines2/4/19978/15/2000
InactiveFidelity and Casualty Company of New York (The)300160Agent - Property8/15/20009/3/2002
InactiveFiremen's Insurance Company of Newark, New Jersey300247Agent - General Lines2/4/19973/31/1998
InactiveFirst Colony Life Insurance Company301179Agent - Life3/22/20011/1/2007
InactiveFirst National Insurance Company of America301690Agent - Casualty10/7/200810/15/2021
InactiveFirst National Insurance Company of America301690Agent - Property10/7/200810/15/2021
InactiveFirst Penn-Pacific Life Insurance Company301581Agent - Health3/7/200112/23/2008
InactiveFirst Penn-Pacific Life Insurance Company301581Agent - Life3/7/200112/23/2008
ActiveFlagship City Insurance Company789965Agent - Casualty3/1/2018 
ActiveFlagship City Insurance Company789965Agent - Property3/1/2018 
InactiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Casualty7/29/201112/20/2023
InactiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Property7/29/201112/20/2023
InactiveGeneral Insurance Company of America300261Agent - Casualty10/7/200810/15/2021
InactiveGeneral Insurance Company of America300261Agent - Property10/7/200810/15/2021
InactiveGenworth Life Insurance Company300623Agent - Health1/7/200612/8/2008
InactiveGenworth Life Insurance Company300623Agent - Life1/7/200612/8/2008
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health3/9/201012/7/2012
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life10/20/201412/14/2016
InactiveGlens Falls Insurance Company (The)301922Agent - General Lines2/3/199712/30/1999
InactiveGreat American Alliance Insurance Company301247Agent - Casualty12/27/20004/29/2019
InactiveGreat American Alliance Insurance Company301247Agent - Property12/27/20004/29/2019
InactiveGreat American Assurance Company300327Agent - Casualty12/27/20004/29/2019
InactiveGreat American Assurance Company300327Agent - Property12/27/20004/29/2019
InactiveGreat American Insurance Company301586Agent - Casualty8/15/20004/29/2019
InactiveGreat American Insurance Company301586Agent - General Lines6/23/19978/15/2000
InactiveGreat American Insurance Company301586Agent - Property8/15/20004/29/2019
InactiveGreat American Insurance Company of New York301897Agent - Casualty12/27/20004/29/2019
InactiveGreat American Insurance Company of New York301897Agent - Property12/27/20004/29/2019
InactiveHartford Life and Accident Insurance Company300878Agent - Health8/17/200412/11/2009
InactiveHartford Life and Accident Insurance Company300878Agent - Life8/17/200412/11/2009
InactiveHumana Health Plan, Inc.300142Agent - Health3/1/20017/14/2014
InactiveHumana Health Plan, Inc.300142Agent - Health Maintenance Organization6/17/19983/1/2001
InactiveHumana Insurance Company301104Agent - Health5/19/19987/14/2014
InactiveHumana Insurance Company301104Agent - Life5/19/19987/14/2014
InactiveHumana Insurance Company of Kentucky300826Agent - Health11/10/20047/14/2014
InactiveHumana Insurance Company of Kentucky300826Agent - Life11/10/20047/14/2014
InactiveHumanaDental Insurance Company301457Agent - Health4/9/201212/19/2012
InactiveHumanaDental Insurance Company301457Agent - Life4/9/201212/19/2012
InactiveIndiana Insurance Company301909Agent - Casualty9/8/20072/3/2023
InactiveIndiana Insurance Company301909Agent - Property9/8/20072/3/2023
InactiveInfinity Casualty Insurance Company301280Agent - General Lines8/3/19906/29/2000
InactiveJefferson-Pilot Life Insurance Company300379Agent - Health6/23/19955/1/1997
InactiveJefferson-Pilot Life Insurance Company300379Agent - Life6/23/19955/1/1997
InactiveKanawha Insurance Company300127Agent - Health4/11/20084/25/2013
InactiveKanawha Insurance Company300127Agent - Life4/11/20084/25/2013
InactiveKansas City Fire and Marine Insurance Company301936Agent - General Lines2/4/199712/30/1999
InactiveKentucky League of Cities Insurance Services Association300026Agent - Casualty5/28/200310/6/2005
InactiveKentucky League of Cities Insurance Services Association300026Agent - Property5/28/200310/6/2005
InactiveKentucky National Insurance Company301625Agent - General Lines2/2/19943/31/1996
InactiveLifeUSA Insurance Company300386Agent - Health5/6/19988/2/2002
InactiveLifeUSA Insurance Company300386Agent - Life5/6/19988/2/2002
InactiveMaryland Casualty Company301719Agent - Casualty8/15/200012/16/2014
InactiveMaryland Casualty Company301719Agent - General Lines10/20/19898/15/2000
InactiveMaryland Casualty Company301719Agent - Property8/15/200012/16/2014
InactiveMassMutual Ascend Life Insurance Company300320Agent - Life8/19/19983/16/2001
InactiveMetLife Investors USA Insurance Company300845Agent - Life1/11/201111/14/2014
InactiveMetropolitan General Insurance Company300709Agent - Casualty8/15/20007/12/2001
InactiveMetropolitan General Insurance Company300709Agent - General Lines8/24/19938/15/2000
InactiveMetropolitan General Insurance Company300709Agent - Property8/15/20007/12/2001
InactiveNational Fire Insurance Company of Hartford301063Agent - Casualty11/6/200212/12/2003
InactiveNational Fire Insurance Company of Hartford301063Agent - General Lines1/17/19898/15/2000
InactiveNational Fire Insurance Company of Hartford301063Agent - Property11/6/200212/12/2003
InactiveNetherlands Insurance Company (The)300339Agent - Casualty9/8/20074/26/2024
InactiveNetherlands Insurance Company (The)300339Agent - Property9/8/20074/26/2024
InactiveNorth American Company for Life and Health Insurance300291Agent - Health1/23/199610/18/2005
InactiveNorth American Company for Life and Health Insurance300291Agent - Life6/11/20136/25/2019
InactiveNorthern Insurance Company of New York301317Agent - Casualty8/15/200012/16/2014
InactiveNorthern Insurance Company of New York301317Agent - General Lines10/20/19898/15/2000
InactiveNorthern Insurance Company of New York301317Agent - Property8/15/200012/16/2014
ActiveOhio Casualty Insurance Company301492Agent - Casualty3/13/2006 
ActiveOhio Casualty Insurance Company301492Agent - Property3/13/2006 
ActiveOhio Security Insurance Company300622Agent - Casualty8/15/2000 
InactiveOhio Security Insurance Company300622Agent - General Lines10/4/19998/15/2000
ActiveOhio Security Insurance Company300622Agent - Property8/15/2000 
InactivePacifiCare Life Assurance Company301082Agent - Health6/18/19987/31/2001
InactivePacifiCare Life Assurance Company301082Agent - Life6/18/19987/31/2001
ActivePeerless Indemnity Insurance Company571682Agent - Casualty9/8/2007 
ActivePeerless Indemnity Insurance Company571682Agent - Property9/8/2007 
ActivePeerless Insurance Company301910Agent - Casualty9/8/2007 
ActivePeerless Insurance Company301910Agent - Property9/8/2007 
ActivePhiladelphia Indemnity Insurance Company301221Agent - Casualty1/19/2010 
ActivePhiladelphia Indemnity Insurance Company301221Agent - Property1/19/2010 
InactivePrincipal Life Insurance Company300129Agent - Health2/23/199311/30/2003
InactivePrincipal Life Insurance Company300129Agent - Life2/23/199311/30/2003
InactiveProtective Life Insurance Company300638Agent - Health4/1/200712/16/2010
InactiveProtective Life Insurance Company300638Agent - Life4/1/200712/16/2010
InactivePruco Life Insurance Company300954Agent - Health10/7/200812/21/2022
InactivePruco Life Insurance Company300954Agent - Life10/7/200812/21/2022
InactiveReassure America Life Insurance Company301902Agent - Health4/18/19899/3/2004
InactiveReassure America Life Insurance Company301902Agent - Life4/18/19899/3/2004
InactiveReliaStar Life Insurance Company301712Agent - Health9/11/200910/5/2012
InactiveReliaStar Life Insurance Company301712Agent - Life9/11/200910/5/2012
ActiveSAFECO Insurance Company of America300159Agent - Casualty10/7/2008 
ActiveSAFECO Insurance Company of America300159Agent - Property10/7/2008 
ActiveSAFECO Insurance Company of Illinois301350Agent - Casualty8/25/2023 
ActiveSAFECO Insurance Company of Illinois301350Agent - Property8/25/2023 
InactiveSecurity Life of Denver Insurance Company300648Agent - Health9/11/20099/29/2012
InactiveSecurity Life of Denver Insurance Company300648Agent - Life9/11/20099/29/2012
InactiveSecurity National Insurance Company301151Agent - General Lines4/13/19892/26/1996
ActiveStandard Fire Insurance Company (The)301068Agent - Casualty2/9/2001 
ActiveStandard Fire Insurance Company (The)301068Agent - Property2/9/2001 
InactiveStandard Insurance Company300185Agent - Health10/8/199112/5/2022
InactiveStandard Insurance Company300185Agent - Life10/8/199112/5/2022
InactiveT.H.E. Insurance Company301854Agent - Casualty10/18/20041/19/2012
InactiveT.H.E. Insurance Company301854Agent - Property10/18/20041/19/2012
InactiveTalcott Resolution Life Insurance Company301759Agent - Health8/17/20048/14/2009
InactiveTalcott Resolution Life Insurance Company301759Agent - Life8/17/20048/14/2009
ActiveThe Phoenix Insurance Company301502Agent - Casualty2/9/2001 
ActiveThe Phoenix Insurance Company301502Agent - Property2/9/2001 
InactiveTime Insurance Company300683Agent - Health2/9/200111/15/2002
InactiveTime Insurance Company300683Agent - Life2/9/200111/15/2002
InactiveTranscontinental Insurance Company301731Agent - Casualty8/15/200012/12/2003
InactiveTranscontinental Insurance Company301731Agent - General Lines1/17/19898/15/2000
InactiveTranscontinental Insurance Company301731Agent - Property8/15/200012/12/2003
InactiveTransportation Insurance Company301575Agent - Casualty8/15/200012/12/2003
InactiveTransportation Insurance Company301575Agent - General Lines1/17/19898/15/2000
InactiveTransportation Insurance Company301575Agent - Property8/15/200012/12/2003
InactiveTravelers Casualty Company of Connecticut301505Agent - Casualty9/3/200212/5/2013
InactiveTravelers Casualty Company of Connecticut301505Agent - Property9/3/200212/5/2013
InactiveTravelers Commercial Insurance Company301506Agent - Casualty2/9/200112/13/2001
InactiveTravelers Commercial Insurance Company301506Agent - Property2/9/200112/13/2001
ActiveTravelers Home and Marine Insurance Company (The)301802Agent - Casualty7/18/2005 
ActiveTravelers Home and Marine Insurance Company (The)301802Agent - Property7/18/2005 
InactiveTravelers Indemnity Company (The)301855Agent - Casualty2/9/200112/5/2013
InactiveTravelers Indemnity Company (The)301855Agent - Property2/9/200112/5/2013
InactiveTravelers Property Casualty Insurance Company301508Agent - Casualty9/3/200212/5/2013
InactiveTravelers Property Casualty Insurance Company301508Agent - Property9/3/200212/5/2013
InactiveTrinity Universal Insurance Company300911Agent - General Lines4/13/19892/26/1996
InactiveU.S. Financial Life Insurance Company301812Agent - Health4/13/20019/5/2007
InactiveU.S. Financial Life Insurance Company301812Agent - Life4/13/20019/5/2007
InactiveUnitedHealthcare Insurance Company300946Agent - Health2/10/200612/14/2009
InactiveUnitedHealthcare Insurance Company300946Agent - Life2/10/200612/14/2009
InactiveUnitedHealthcare Life Insurance Company301517Agent - Health10/3/19953/31/1997
InactiveUnitedHealthcare Life Insurance Company301517Agent - Life10/3/19953/31/1997
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health2/10/200612/14/2009
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health2/10/200612/14/2009
InactiveUnitrin Auto and Home Insurance Company301538Agent - Casualty9/20/201210/23/2024
InactiveUnitrin Auto and Home Insurance Company301538Agent - Property9/20/201210/23/2024
InactiveUnitrin Preferred Insurance Company502869Agent - Casualty9/20/201212/2/2013
InactiveUnitrin Preferred Insurance Company502869Agent - Property9/20/201212/2/2013
InactiveWashington National Insurance Company300587Agent - Life10/1/201012/30/2010
ActiveWest American Insurance Company301112Agent - Casualty3/13/2006 
ActiveWest American Insurance Company301112Agent - Property3/13/2006 
InactiveWest Coast Life Insurance Company301607Agent - Health11/3/200911/16/2011
InactiveWest Coast Life Insurance Company301607Agent - Life11/3/200911/16/2011
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Health9/19/20072/16/2010
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Life9/19/20072/16/2010
InactiveWilcac Life Insurance Company301573Agent - Health4/18/198911/17/2000
InactiveWilcac Life Insurance Company301573Agent - Life4/18/198911/17/2000
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveDental Choice Agency Inc.398085Agent - Health1/29/2002 
ActiveDesignated Agent Company Inc.681257Agent - Life12/11/2013 
ActiveDesignated Agent Company Inc.681257Agent - Health12/11/2013 
ActiveE. N. Dornbusch Agency Inc.398456Agent - Life6/9/1993 
ActiveE. N. Dornbusch Agency Inc.398456Agent - Health6/9/1993 
InactiveE. N. Dornbusch Agency Inc.398456Agent - General Lines6/9/19938/15/2000
ActiveE. N. Dornbusch Agency Inc.398456Agent - Property8/15/2000 
ActiveE. N. Dornbusch Agency Inc.398456Agent - Casualty8/15/2000 

© Commonwealth of Kentucky. All rights reserved.