DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Beatrice, Gerald R	DOIID	359269	NAIC NPN	2223186

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health Maintenance Organization	4/2/1997	3/1/2001
Inactive	Resident	Agent	Health	4/30/1997	4/30/2008
Inactive	Resident	Agent	Life	9/25/2000	4/30/2008
AFFIDAVIT ON FILE
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Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	7/5/1997	4/7/2004
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/25/2000	4/30/2008
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Health	11/20/2000	11/3/2005
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Life	11/20/2000	11/3/2005
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/7/2006	4/30/2008
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	4/2/1997	10/6/1997
Inactive	Humana Insurance Company	300118	Agent - Health	4/30/1997	10/6/1997
Inactive	Humana Insurance Company	301104	Agent - Health	4/7/2006	4/30/2008
Inactive	Humana Insurance Company	301104	Agent - Life	4/7/2006	4/30/2008
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	4/7/2006	4/30/2008
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	4/7/2006	4/30/2008
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	12/7/2000	4/30/2008
Inactive	PacifiCare of Ohio Inc.	301904	Agent - Health	3/1/2001	3/31/2001
Inactive	PacifiCare of Ohio Inc.	301904	Agent - Health Maintenance Organization	7/23/1997	3/1/2001
Inactive	United World Life Insurance Company	300532	Agent - Health	9/28/2004	4/30/2008
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	9/22/2004	4/30/2008
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	9/22/2004	4/30/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Business Benefits Inc	400111	Agent - Health	11/30/2000	4/30/2008
Inactive	Business Benefits Inc	400111	Agent - Life	11/13/2000	4/30/2008
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	3/28/2002	4/30/2008