DEPARTMENT OF INSURANCE

Affiliations

Name	Custenborder, Patrick Raymond	DOIID	356268	NAIC NPN	1488988

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	9/5/1995		3/31/2027
Active	Non Resident	Agent	Health	9/5/1995		3/31/2027
Inactive	Non Resident	Agent	Health Maintenance Organization	12/30/1998	3/1/2001
* 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
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/4/2025
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/23/2021	12/19/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/23/2021
Inactive	Banner Life Insurance Company	301696	Agent - Life	1/30/2015	10/7/2017
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/23/2021
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	7/6/2012
Inactive	Guarantee Life Insurance Company	301560	Agent - Health	9/5/1995	9/8/2000
Inactive	Guarantee Life Insurance Company	301560	Agent - Life	9/5/1995	9/8/2000
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	12/16/2009	11/23/2012
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	12/16/2009	11/23/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	7/6/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	12/30/1998	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	12/10/1998	7/6/2012
Inactive	Humana Insurance Company	301104	Agent - Life	12/10/1998	7/6/2012
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	9/8/2000	7/2/2007
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	9/8/2000	7/2/2007
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	7/6/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	7/6/2012
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	7/2/2007	3/18/2009
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	7/2/2007	3/18/2009
Active	Pan-American Life Insurance Company	301530	Agent - Health	1/6/2025
Active	Pan-American Life Insurance Company	301530	Agent - Life	1/6/2025
Inactive	Time Insurance Company	300683	Agent - Health	3/11/2008	11/23/2019
Inactive	Time Insurance Company	300683	Agent - Life	3/11/2008	11/23/2019
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	8/13/1997	12/19/2005
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	8/13/1997	12/19/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBISA Reaquisitian Corp	547026	Agent - Life	9/4/2008	11/23/2019
Inactive	CBISA Reaquisitian Corp	547026	Agent - Health	9/4/2008	11/23/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/6/2013	11/23/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/6/2013	11/23/2019
Active	Phelan Insurance Agency Inc.	512633	Agent - Life	3/6/2019
Active	Phelan Insurance Agency Inc.	512633	Agent - Health	3/6/2019