DEPARTMENT OF INSURANCE

Affiliations

Name	Fath, Randall E	DOIID	349256	NAIC NPN	2759224

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health Maintenance Organization	8/25/1988	3/1/2001
Inactive	Non Resident	Agent	Life	4/13/2014	1/31/2016
Inactive	Non Resident	Agent	Health	4/13/2014	1/31/2016
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	4/13/2014	1/31/2016
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc.	300694	Agent - Health	7/8/2000	12/31/2007
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007	7/8/2010
Inactive	Aetna Life Insurance Company	301140	Agent - Health	7/28/2000	7/8/2010
Inactive	Aetna Life Insurance Company	301140	Agent - Life	7/28/2000	7/8/2010
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	2/8/2005	11/20/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	2/8/2005	11/20/2007
Inactive	American United Life Insurance Company	300498	Agent - Health	7/15/2013	1/31/2014
Inactive	American United Life Insurance Company	300498	Agent - Life	7/15/2013	1/31/2014
Inactive	American United Life Insurance Company	300498	Agent - Variable Life and Variable Annuities	7/19/2013	1/31/2014
Inactive	Ameritas Variable Life Insurance Company	300665	Agent - Health	4/1/1996	6/27/1997
Inactive	Ameritas Variable Life Insurance Company	300665	Agent - Life	4/1/1996	6/27/1997
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/1/2001	4/1/2002
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	8/25/1988	3/1/2001
Inactive	Athene Annuity and Life Company	301893	Agent - Health	8/15/1988	3/30/1998
Inactive	Athene Annuity and Life Company	301893	Agent - Life	6/8/2011	1/8/2014
Inactive	Banner Life Insurance Company	301696	Agent - Life	3/7/2013	1/31/2014
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	3/31/2000	10/27/2006
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	3/31/2000	10/27/2006
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/30/2015	12/8/2015
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	8/18/1998	5/15/2006
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	8/18/1998	5/15/2006
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	7/30/2015	12/8/2015
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Health	5/4/1999	12/18/2000
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	5/4/1999	12/18/2000
Inactive	First Colony Life Insurance Company	301179	Agent - Life	5/20/2005	1/1/2007
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	4/6/2000	12/23/2008
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	4/6/2000	12/23/2008
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	12/4/2007
Inactive	Guardian Insurance & Annuity Company Inc. (The)	301920	Agent - Life	3/11/2013	2/10/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	7/30/2015	12/8/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	10/29/1996	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	7/30/2015	12/8/2015
Inactive	Humana Insurance Company	301104	Agent - Life	7/30/2015	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	7/30/2015	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	7/30/2015	12/8/2015
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	8/28/2006	7/2/2007
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	8/28/2006	7/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	8/28/2006	4/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	8/28/2006	4/2/2007
Inactive	Kanawha Insurance Company	300127	Agent - Health	7/30/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	7/30/2015	10/22/2015
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	5/4/2000	6/26/2003
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	5/4/2000	6/26/2003
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	8/15/1994	8/7/2013
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	8/15/1994	8/7/2013
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Variable Life and Variable Annuities	5/31/2001	8/7/2013
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	1/3/2001	12/18/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	1/3/2001	12/18/2012
Inactive	Pioneer Mutual Life Insurance Company	501695	Agent - Health	7/15/2013	1/31/2014
Inactive	Pioneer Mutual Life Insurance Company	501695	Agent - Life	7/15/2013	1/31/2014
Inactive	Prudential Health Care Plan Inc.	301342	Agent - Health	3/1/2001	5/21/2003
Inactive	Prudential Health Care Plan Inc.	301342	Agent - Health Maintenance Organization	4/29/1997	3/1/2001
Inactive	Prudential Insurance Company of America	300784	Agent - Health	4/21/1997	12/17/2004
Inactive	Prudential Insurance Company of America	300784	Agent - Life	4/21/1997	12/17/2004
Inactive	State Life Insurance Company	301497	Agent - Health	11/29/2012	1/31/2014
Inactive	State Life Insurance Company	301497	Agent - Life	11/29/2012	1/31/2014

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	3/3/2000	5/10/2001
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	3/3/2000	5/10/2001