DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Simon, Stephen Lawrence	DOIID	337264	NAIC NPN	1491909

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/23/1997	11/30/2003
Inactive	Non Resident	Agent	Health Maintenance Organization	12/8/1997	3/1/2001
Inactive	Non Resident	Agent	Life	10/23/1997	1/16/2002
* 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	3/1/2001	11/30/2003
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	12/8/1997	11/12/1998
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	4/28/1998	11/12/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/23/1997	2/8/1999
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/23/1997	2/8/1999
Inactive	Southeastern United Medigroup Inc.	300198	Agent - Health Maintenance Organization	12/8/1997	3/1/2001

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	3/5/1998	1/16/2002
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	3/5/1998	2/28/2003