DEPARTMENT OF INSURANCE

Affiliations

Name	Blackwell, Rita	DOIID	328971	NAIC NPN	7175810

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	12/6/1995	1/1/2012
Inactive	Resident	Agent	Health Maintenance Organization	12/28/1995	2/8/2001
Inactive	Resident	Agent	Life	12/6/1995	1/1/2012
* 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	Allianz Life Insurance Company of North America	301791	Agent - Health	7/23/2001	11/20/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	7/23/2001	11/20/2007
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	12/28/1995	2/8/2001
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	5/13/1998	2/8/2001
Inactive	Anthem Life Insurance Company	301209	Agent - Health	12/6/1995	12/22/1999
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/6/1995	12/22/1999
Inactive	Banner Life Insurance Company	301696	Agent - Life	1/18/2002	1/1/2012
Inactive	Delaware Life Insurance Company	301256	Agent - Life	10/10/2006	1/1/2012
Inactive	First Colony Life Insurance Company	301179	Agent - Health	3/18/2003	12/20/2006
Inactive	First Colony Life Insurance Company	301179	Agent - Life	3/18/2003	12/20/2006
Inactive	Golden Rule Insurance Company	301943	Agent - Health	10/25/2005	11/10/2008
Inactive	Golden Rule Insurance Company	301943	Agent - Life	10/25/2005	11/10/2008
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/17/2003	11/20/2009
Inactive	Humana Insurance Company	301104	Agent - Health	1/15/2003	11/20/2009
Inactive	Humana Insurance Company	301104	Agent - Life	1/15/2003	11/20/2009
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	3/2/2001	1/4/2011
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	3/2/2001	1/4/2011
Inactive	Time Insurance Company	300683	Agent - Health	2/2/2001	8/4/2010
Inactive	Time Insurance Company	300683	Agent - Life	2/2/2001	8/4/2010
Inactive	Union Security Insurance Company	301844	Agent - Health	1/22/2001	11/22/2002
Inactive	Union Security Insurance Company	301844	Agent - Life	1/22/2001	11/22/2002
Inactive	United Concordia Dental Plans of Kentucky Inc.	301923	Agent - Health	12/2/2002	12/28/2006
Inactive	United Concordia Life and Health Insurance Company	301220	Agent - Health	12/2/2002	12/28/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia Senior of The Southeast Inc.	401297	Agent - Life	1/16/1996	2/10/2004
Inactive	Acordia Senior of The Southeast Inc.	401297	Agent - Health	1/16/1996	2/10/2004
Inactive	Medlink Inc	400721	Agent - Life	9/12/2002	1/1/2012
Inactive	Medlink Inc	400721	Agent - Health	9/12/2002	1/4/2011
Inactive	P T Marketing, Inc.	588051	Agent - Life	7/18/2007	1/1/2012
Inactive	P T Marketing, Inc.	588051	Agent - Health	7/18/2007	1/4/2011