DEPARTMENT OF INSURANCE

Affiliations

Name	Siereveld Cic, Steven Arthur	DOIID	348028	NAIC NPN	1890527

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Denied	Resident	Agent	Personal Lines
Inactive	Resident	Agent	General Lines	12/31/1986	8/15/2000
Inactive	Resident	Agent	Health	11/16/2020	11/30/2023
Inactive	Resident	Agent	Casualty	11/16/2020	11/30/2023
Inactive	Resident	Agent	Prepaid Dental Plan	11/12/1999	3/1/2001
Inactive	Resident	Agent	Health Maintenance Organization	9/17/1998	3/1/2001
Inactive	Resident	Agent	Life	11/16/2020	11/30/2023
Inactive	Resident	Agent	Property	11/16/2020	11/30/2023
* 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	ACE American Insurance Company	300625	Agent - General Lines	12/31/1986	3/31/1998
Inactive	ACE American Insurance Company	300625	Agent - Health	5/8/2000	7/1/2002
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - General Lines	12/31/1986	3/31/1998
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - General Lines	12/31/1986	3/31/1998
Inactive	Aetna Life Insurance Company	301140	Agent - Health	2/19/1997	7/1/2002
Inactive	Aetna Life Insurance Company	301140	Agent - Life	2/19/1997	7/1/2002
Inactive	American Alternative Insurance Corporation	301697	Agent - Casualty	6/30/2008	11/30/2013
Inactive	American Alternative Insurance Corporation	301697	Agent - General Lines	6/7/1996	8/15/2000
Inactive	American Alternative Insurance Corporation	301697	Agent - Property	6/30/2008	11/30/2013
Inactive	American General Life Insurance Company	301585	Agent - Health	4/23/2014	12/1/2019
Inactive	American General Life Insurance Company	301585	Agent - Life	4/23/2014	12/1/2019
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	8/5/2003	12/31/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	8/5/2003	12/31/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	4/17/1996	3/13/2000
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/17/1996	3/13/2000
Inactive	Assurity Life Insurance Company	301099	Agent - Health	10/21/2003	4/5/2005
Inactive	Assurity Life Insurance Company	301099	Agent - Life	10/21/2003	4/5/2005
Inactive	Augustar Life Insurance Company	301816	Agent - Health	4/12/1993	3/31/1997
Inactive	Augustar Life Insurance Company	301816	Agent - Life	4/12/1993	3/31/1997
Inactive	Bankers Standard Insurance Company	301620	Agent - General Lines	12/31/1986	3/31/1998
Inactive	Century Indemnity Company	301310	Agent - General Lines	12/31/1986	3/31/1998
Inactive	Combined Insurance Company of America	301472	Agent - Health	4/22/2014	12/1/2019
Inactive	Combined Insurance Company of America	301472	Agent - Life	4/22/2014	12/1/2019
Inactive	CompDent Corporation	301387	Agent - Health	3/1/2001	7/1/2002
Inactive	CompDent Corporation	301387	Agent - Prepaid Dental Plan	11/12/1999	3/1/2001
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	10/24/1990	7/1/2002
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	10/24/1990	7/1/2002
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/9/2002	11/27/2010
Inactive	EMC National Life Company	300388	Agent - Life	12/9/2002	11/8/2012
Inactive	Employers Mutual Casualty Company	300202	Agent - Casualty	4/3/2006	8/28/2008
Inactive	Employers Mutual Casualty Company	300202	Agent - Property	4/3/2006	8/28/2008
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Health	9/18/1996	7/1/2002
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	9/18/1996	7/1/2002
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	12/4/1999	7/1/2002
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	12/4/1999	7/1/2002
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	8/15/2000	7/1/2002
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - General Lines	12/30/1996	8/15/2000
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Property	8/15/2000	7/1/2002
Inactive	First Colony Life Insurance Company	301179	Agent - Life	5/4/1998	7/1/2002
Inactive	Hamilton Mutual Insurance Company	301111	Agent - Casualty	4/3/2006	8/28/2008
Inactive	Hamilton Mutual Insurance Company	301111	Agent - Property	4/3/2006	8/28/2008
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	2/11/2005	9/28/2007
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	2/11/2005	9/28/2007
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/9/2002	11/27/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	9/17/1998	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	12/5/2002	11/27/2010
Inactive	Humana Insurance Company	301104	Agent - Life	12/5/2002	11/27/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/29/2004	11/27/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/29/2004	11/27/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Health	12/9/2002	11/27/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Life	12/9/2002	11/27/2010
Inactive	Indemnity Insurance Company of North America	301760	Agent - General Lines	12/31/1986	3/31/1998
Inactive	Insurance Company of North America	300226	Agent - General Lines	12/31/1986	3/31/1998
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	8/8/2001	7/1/2002
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	5/1/1996	3/10/1997
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	5/1/1996	3/10/1997
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	11/27/2010
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	11/27/2010
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	3/29/1994	10/2/1996
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	3/29/1994	10/2/1996
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	3/22/2007	6/25/2008
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	3/22/2007	6/25/2008
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	1/10/2005	11/30/2013
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - General Lines	2/5/1987	8/15/2000
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	6/20/2016	12/1/2019
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	1/10/2005	11/30/2013
Inactive	National Western Life Insurance Company	301515	Agent - Health	5/14/1998	7/1/2002
Inactive	National Western Life Insurance Company	301515	Agent - Life	5/14/1998	7/1/2002
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Health	4/19/2001	7/1/2002
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Life	4/19/2001	7/1/2002
Inactive	Optum Insurance of Ohio, Inc	301226	Agent - Health	7/18/1996	3/31/1997
Inactive	Optum Insurance of Ohio, Inc	301226	Agent - Life	7/18/1996	3/31/1997
Inactive	PacifiCare Life Assurance Company	301082	Agent - Health	6/22/1998	7/31/2001
Inactive	PacifiCare Life Assurance Company	301082	Agent - Life	6/22/1998	7/31/2001
Inactive	Pacific Employers Insurance Company	301753	Agent - General Lines	12/31/1986	3/31/1998
Inactive	Protective Life Insurance Company	300638	Agent - Health	12/22/1992	4/5/1999
Inactive	Protective Life Insurance Company	300638	Agent - Life	12/22/1992	4/5/1999
Inactive	Security Financial Life Insurance Company	300208	Agent - Health	3/1/2003	5/13/2004
Inactive	Security Financial Life Insurance Company	300208	Agent - Life	3/1/2003	5/13/2004
Inactive	Standard Insurance Company	300185	Agent - Health	6/2/2003	11/30/2013
Inactive	Standard Insurance Company	300185	Agent - Life	6/2/2003	11/30/2013
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	2/11/2005	11/16/2011
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	2/11/2005	11/16/2011
Inactive	USG Annuity & Life Company	300457	Agent - Health	4/29/1997	7/1/2002
Inactive	USG Annuity & Life Company	300457	Agent - Life	4/29/1997	7/1/2002
Inactive	Woodmen Accident and Life Company	300147	Agent - Health	7/24/1997	12/18/1998
Inactive	Woodmen Accident and Life Company	300147	Agent - Life	7/24/1997	12/18/1998

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kentucky Public Entity Programs Inc	400082	Agent - Life	7/10/2013	11/30/2013
Inactive	Kentucky Public Entity Programs Inc	400082	Agent - Health	7/10/2013	11/30/2013
Inactive	Kentucky Public Entity Programs Inc	400082	Agent - General Lines	5/18/1987	8/15/2000
Inactive	Kentucky Public Entity Programs Inc	400082	Agent - Property	7/10/2013	11/30/2013
Inactive	Kentucky Public Entity Programs Inc	400082	Agent - Casualty	7/10/2013	11/30/2013