DEPARTMENT OF INSURANCE

Affiliations

Name	Bain, Mark Alan	DOIID	340808	NAIC NPN	1486808

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	1/9/2022		5/31/2026
Active	Non Resident	Agent	Health	1/9/2022		5/31/2026
Inactive	Non Resident	Agent	Property	10/13/2013	5/31/2020
Inactive	Non Resident	Agent	Casualty	10/13/2013	5/31/2020
Inactive	Resident	Agent	General Lines	12/26/1996	8/15/2000
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	03/15/2024	05/31/2024	05/31/2024	05/31/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AAA Life Insurance Company	300287	Agent - Health	12/9/2022	8/10/2023
Inactive	AAA Life Insurance Company	300287	Agent - Life	12/9/2022	8/10/2023
Inactive	Ability Insurance Company	301013	Agent - Health	1/8/2002	7/1/2002
Inactive	Ability Insurance Company	301013	Agent - Life	1/8/2002	7/1/2002
Inactive	American General Life Insurance Company	301585	Agent - Health	8/1/2017	12/23/2019
Inactive	American General Life Insurance Company	301585	Agent - Life	8/1/2017	12/23/2019
Inactive	American National General Insurance Company	301944	Agent - Casualty	10/15/2013	11/9/2014
Inactive	American National General Insurance Company	301944	Agent - Property	10/15/2013	11/9/2014
Inactive	American National Insurance Company	301861	Agent - Life	10/4/2013	11/9/2014
Inactive	American National Property and Casualty Company	300392	Agent - Casualty	10/15/2013	11/9/2014
Inactive	American National Property and Casualty Company	300392	Agent - Property	10/15/2013	11/9/2014
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	7/10/2017	2/28/2018
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	6/12/1995	3/31/1997
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	6/12/1995	3/31/1997
Inactive	Conseco Health Insurance Company	301725	Agent - Health	2/6/2002	7/1/2002
Inactive	Conseco Health Insurance Company	301725	Agent - Life	2/6/2002	7/1/2002
Inactive	Continental Casualty Company	301019	Agent - Health	11/21/1997	7/1/1998
Inactive	Countryway Insurance Company	300809	Agent - General Lines	12/26/1996	7/1/1998
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	1/21/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	2/26/2014	1/20/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	2/26/2014	1/20/2015
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	11/2/1995	7/1/1998
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Health	11/9/2022	8/10/2023
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Life	11/9/2022	8/10/2023
Inactive	Golden Rule Insurance Company	301943	Agent - Health	5/10/1995	3/31/1997
Inactive	Golden Rule Insurance Company	301943	Agent - Life	5/10/1995	3/31/1997
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Health	1/9/2002	7/1/2002
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Life	1/9/2002	7/1/2002
Inactive	Lumico Life Insurance Company	300354	Agent - Life	12/2/2022	3/7/2023
Inactive	Metropolitan General Insurance Company	300709	Agent - General Lines	12/15/1997	7/1/1998
Inactive	Midland Life Insurance Company (The)	300310	Agent - Health	1/14/1997	7/1/1998
Inactive	Midland Life Insurance Company (The)	300310	Agent - Life	1/14/1997	7/1/1998
Inactive	National Teachers Associates Life Insurance Company	300107	Agent - Health	9/18/2014	2/9/2015
Inactive	National Teachers Associates Life Insurance Company	300107	Agent - Life	9/18/2014	2/9/2015
Inactive	PAFCO General Insurance Company	301645	Agent - General Lines	12/18/1997	7/1/1998
Inactive	Pioneer Life Insurance Company	300110	Agent - Health	9/25/1996	3/9/1998
Inactive	Pioneer Life Insurance Company	300110	Agent - Life	9/25/1996	3/9/1998
Inactive	Progressive Max Insurance Company	301034	Agent - General Lines	11/12/1998	8/15/2000
Inactive	Progressive Northern Insurance Company	301378	Agent - General Lines	12/14/1998	8/15/2000
Inactive	Progressive Northwestern Insurance Company	300441	Agent - General Lines	12/14/1998	8/15/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	12/19/1995	7/1/1998
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	12/19/1995	7/1/1998
Inactive	Prudential Insurance Company of America	300784	Agent - Health	5/16/1997	7/1/1998
Inactive	Prudential Insurance Company of America	300784	Agent - Life	5/16/1997	7/1/1998
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	1/16/2002	7/1/2002
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	1/16/2002	7/1/2002
Inactive	SunAmerica Annuity and Life Assurance Company	301930	Agent - Life	12/8/1999	7/1/2002
Inactive	SunAmerica Life Insurance Company	300096	Agent - Life	12/8/1999	7/1/2002
Inactive	Transamerica Financial Life Insurance Company	301288	Agent - Health	12/28/1995	7/1/1998
Inactive	Transamerica Financial Life Insurance Company	301288	Agent - Life	12/28/1995	7/1/1998
Inactive	Union Security Insurance Company	301844	Agent - Health	9/5/1995	7/1/1998
Inactive	Union Security Insurance Company	301844	Agent - Life	9/5/1995	7/1/1998
Inactive	United American Insurance Company	300910	Agent - Health	10/10/2001	2/5/2002
Inactive	United American Insurance Company	300910	Agent - Life	10/10/2001	2/5/2002
Inactive	United Investors Life Insurance Company	301873	Agent - Life	11/5/2001	2/5/2002
Active	United of Omaha Life Insurance Company	300156	Agent - Health	10/28/2022
Active	United of Omaha Life Insurance Company	300156	Agent - Life	10/28/2022
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/29/1994	3/31/1997
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/29/1994	3/31/1997
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Health	9/10/1999	7/1/2002
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Life	9/10/1999	7/1/2002
Inactive	Western Surety Company	300283	Agent - General Lines	12/23/1998	5/27/1999
Inactive	Zurich American Life Insurance Company	300216	Agent - Life	6/12/1995	7/1/1998

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	6/25/1996	7/1/1998
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/25/1996	7/1/1998
Inactive	CCIT Insurance Services, LLC	541200	Agent - Life	12/20/2001	6/6/2002
Inactive	CCIT Insurance Services, LLC	541200	Agent - Health	12/20/2001	6/6/2002
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Inactive	National Teacher Associates of Kentucky Inc.	399320	Agent - Life	10/8/2014	2/26/2015
Inactive	National Teacher Associates of Kentucky Inc.	399320	Agent - Health	10/8/2014	2/26/2015
Inactive	Senior American Benefits, LLC	502287	Agent - Life	12/20/2001	7/1/2002
Inactive	Senior American Benefits, LLC	502287	Agent - Health	12/20/2001	7/1/2002
Inactive	West Kentucky Group Benefits	401049	Agent - Life	12/28/1998	7/1/2002
Inactive	West Kentucky Group Benefits	401049	Agent - Health	12/28/1998	7/1/2002
Inactive	World Marketing Alliance Inc.	398156	Agent - Life	10/23/1997	7/1/1998
Inactive	World Marketing Alliance Inc.	398156	Agent - Health	10/23/1997	7/1/1998