DEPARTMENT OF INSURANCE

Affiliations

Name	Pena, William Thomas	DOIID	336509	NAIC NPN	7185546

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	General Lines	11/6/1991	3/31/1996
Inactive	Resident	Agent	Life	3/14/2006	6/30/2013
Inactive	Resident	Agent	Health	7/28/2015	6/30/2021
Inactive	Resident	Independent Adjuster	Property & Casualty	6/30/1994	7/1/2011
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	2/21/2011	6/30/2013
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	2/21/2011	10/12/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	6/6/2007	6/30/2013
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/6/2007	6/30/2013
Inactive	Banner Life Insurance Company	301696	Agent - Health	1/28/2009	6/30/2013
Inactive	Banner Life Insurance Company	301696	Agent - Life	1/28/2009	8/5/2011
Inactive	CareSource Kentucky Co.	838179	Agent - Health	8/20/2015	3/16/2017
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/18/2008	7/10/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Health	7/18/2008	7/10/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	7/18/2008	7/10/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	7/10/2013
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - General Lines	11/6/1991	3/31/1996
Inactive	Golden Rule Insurance Company	301943	Agent - Health	6/7/2007	12/13/2012
Inactive	Golden Rule Insurance Company	301943	Agent - Life	6/7/2007	12/13/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/20/2009	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Health	3/7/2009	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Life	3/7/2009	7/10/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	7/10/2008	7/10/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	7/10/2008	7/10/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Health	7/10/2008	2/22/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	7/10/2008	2/22/2012
Inactive	John Alden Life Insurance Company	300573	Agent - Health	6/1/1993	7/1/1998
Inactive	John Alden Life Insurance Company	300573	Agent - Life	6/1/1993	7/1/1998
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/10/2011	4/25/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/10/2011	4/25/2013
Inactive	West Coast Life Insurance Company	301607	Agent - Health	3/7/2009	11/16/2011
Inactive	West Coast Life Insurance Company	301607	Agent - Life	3/7/2009	11/16/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/6/2007	6/23/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/6/2007	6/23/2008
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/25/2008	2/21/2011
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/25/2008	2/21/2011
Inactive	Kentucky Risk Management	401294	Independent Adjuster - Property & Casualty	6/30/1994	11/20/1998
Inactive	Medlink Inc	400721	Agent - Health	11/7/2016	3/16/2017