DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Ballard, G Thomas	DOIID	355991	NAIC NPN	7101737

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Adjuster	Independent	2/28/1994	11/30/2005
Denied	Resident	Agent	Life
Inactive	Resident	Agent	Health	8/4/2015	12/1/2017
* 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	8/7/2015	11/2/2016
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health	10/8/2015	12/1/2017
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/25/2015	12/13/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/25/2015	12/13/2016
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	8/25/2015	4/10/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	8/25/2015	4/10/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/25/2015	4/10/2017
Inactive	Humana Insurance Company	301104	Agent - Health	8/25/2015	4/10/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/25/2015	4/10/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	8/25/2015	4/10/2017
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	4/10/2017
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/25/2015	10/22/2015
Inactive	Medico Corp Life Insurance Company	301777	Agent - Health	12/18/2015	12/21/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/3/2015	3/10/2017
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/13/2016	3/10/2017
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	9/3/2015	12/5/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/12/2015	3/10/2017

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 - Health	8/7/2015	11/2/2016
Inactive	Dixon Adjusters Inc	401249	Adjuster - Independent	2/28/1994	3/31/1998
Inactive	Dixon-Ballard Adjusters Inc.	401308	Adjuster - Independent	3/31/1998	11/30/2005

Sponsorships

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Lykins, Lorie Lyn	306105	Apprentice Adjuster - Not Applicable	9/16/1996	10/14/1997
Inactive	Patton-Morris, Mary Alice	542351	Apprentice Adjuster - Not Applicable	12/7/2001	6/5/2002