DEPARTMENT OF INSURANCE

Affiliations

Name	Stautberg, Thomas J	DOIID	348360	NAIC NPN	1775313

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	8/3/2000	10/31/2021
Inactive	Non Resident	Agent	Health	8/3/2000	10/31/2021
* 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	Aetna Health Inc.	300694	Agent - Health	7/6/2004	12/31/2007
Inactive	Aetna Health Inc.	300694	Agent - Life	7/6/2004	12/31/2007
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	11/13/2018	5/12/2019
Inactive	Aetna Health Inc. (PA)	660717	Agent - Life	12/31/2007	9/21/2010
Inactive	Aetna Life Insurance Company	301140	Agent - Health	11/13/2018	5/12/2019
Inactive	Aetna Life Insurance Company	301140	Agent - Life	11/13/2018	5/12/2019
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/17/2009	10/31/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/17/2009	10/31/2021
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	2/11/2013	10/5/2021
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	2/11/2013	10/5/2021
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/11/2016	12/13/2016
Inactive	CompBenefits Insurance Company	301864	Agent - Health	8/6/2012	6/26/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	8/6/2012	6/26/2013
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	8/25/2009	6/11/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	8/25/2009	6/11/2014
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	11/12/2018	5/12/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/24/2021	10/31/2021
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Health	6/23/2005	3/8/2011
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	6/23/2005	3/8/2011
Inactive	Guardian Insurance & Annuity Company Inc. (The)	301920	Agent - Life	2/11/2013	10/5/2021
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	2/11/2013	10/5/2021
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	2/11/2013	10/5/2021
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	2/1/2010	11/30/2014
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	2/1/2010	11/30/2014
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/5/2014	12/8/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	2/27/2013	12/8/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	6/24/2021	10/31/2021
Inactive	Humana Insurance Company	301104	Agent - Health	6/24/2021	10/31/2021
Inactive	Humana Insurance Company	301104	Agent - Life	7/10/2007	5/2/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	6/24/2021	10/31/2021
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	6/24/2021	10/31/2021
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	11/5/2014	12/8/2015
Inactive	HumanaDental Insurance Company	301457	Agent - Health	8/6/2012	12/19/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	8/6/2012	12/19/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/14/2015	10/14/2016
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/14/2015	10/14/2016
Inactive	Life Insurance Company of North America	300711	Agent - Health	8/25/2009	10/31/2021
Inactive	Life Insurance Company of North America	300711	Agent - Life	8/25/2009	10/31/2021
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	4/16/2010	11/9/2012
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	6/26/2008	12/21/2013
Inactive	Penn Insurance and Annuity Company	300712	Agent - Life	3/27/2019	10/31/2021
Inactive	Penn Mutual Life Insurance Company	301394	Agent - Life	3/27/2019	10/31/2021
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	8/3/2000	9/9/2015
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	8/3/2000	9/9/2015
Inactive	Swiss Re Corporate Solutions America Insurance Corporation	300338	Agent - Health	5/11/2021	10/31/2021
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	12/29/2009	9/9/2015
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	12/29/2009	9/9/2015
Inactive	Unimerica Insurance Company	563724	Agent - Health	6/8/2009	10/31/2021
Inactive	Unimerica Insurance Company	563724	Agent - Life	6/8/2009	10/31/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	6/26/2008	12/22/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	6/26/2008	12/22/2021
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/25/2008	11/30/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	6/25/2008	11/30/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	6/25/2008	11/30/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	6/25/2008	11/30/2016
Inactive	Westport Insurance Corporation	301875	Agent - Health	10/6/2020	10/31/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	8/17/2009	10/31/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	8/17/2009	10/31/2021
Inactive	W Group Of Ohio LLC The	553986	Agent - Life	1/25/2007	3/31/2009
Inactive	W Group Of Ohio LLC The	553986	Agent - Health	1/25/2007	3/31/2009