DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Donnelly, Dolores W	DOIID	363841	NAIC NPN	3743412

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health Maintenance Organization	9/2/1986	3/1/2001
Inactive	Resident	Agent	Life	6/21/2002	9/9/2010
Inactive	Resident	Agent	Health	6/29/2000	9/9/2010
* 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 Life Insurance Company	301209	Agent - Health	5/19/2008	7/8/2010
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/19/2008	7/8/2010
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	9/8/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	9/8/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	9/2/1986	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	6/21/2002	9/8/2010
Inactive	Humana Insurance Company	301104	Agent - Life	6/21/2002	9/8/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/17/2007	9/8/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	5/17/2007	9/8/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Health	5/17/2007	9/8/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Life	5/17/2007	9/8/2010
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/29/2000	1/11/2002
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	6/29/2000	1/11/2002
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/1/2001	12/4/2001
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	2/14/2000	3/1/2001

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	5/17/2008	6/21/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	5/17/2008	6/21/2008
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/28/2008	9/8/2010
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/28/2008	9/8/2010
Inactive	Medlink Inc	400721	Agent - Life	7/18/2008	9/8/2010
Inactive	Medlink Inc	400721	Agent - Health	7/18/2008	9/8/2010