DEPARTMENT OF INSURANCE

Affiliations

Name	Kirven, Marsha Ann	DOIID	371318	NAIC NPN	7200786

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	2/14/1990	2/19/2005
Inactive	Resident	Agent	Life	3/24/1992	2/19/2005
Inactive	Resident	Agent	Health Maintenance Organization	2/20/1990	3/1/2001
Inactive	Resident	Agent	Prepaid Dental Plan	11/6/1998	2/23/2000
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	Aetna Health Inc.	300694	Agent - Health	3/1/2001	12/11/2002
Inactive	Aetna Health Inc.	300694	Agent - Health Maintenance Organization	12/1/1999	3/1/2001
Inactive	Aetna Life Insurance Company	301140	Agent - Health	12/8/1992	12/11/2002
Inactive	Aetna Life Insurance Company	301140	Agent - Life	12/8/1992	12/11/2002
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	2/20/1990	3/1/2001
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	2/14/1990	3/31/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/3/2000	12/11/2002
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/3/2000	12/11/2002
Inactive	Dearborn Life Insurance Company	300401	Agent - Health	12/31/2004	2/19/2005
Inactive	Dearborn Life Insurance Company	300401	Agent - Life	12/31/2004	2/19/2005
Inactive	Dental Plan Managers Inc.	300547	Agent - Prepaid Dental Plan	11/6/1998	2/23/2000
Inactive	General American Life Insurance Company	300280	Agent - Health	7/18/1995	6/4/1999
Inactive	General American Life Insurance Company	300280	Agent - Life	7/18/1995	6/4/1999
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	9/13/2002
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	6/12/1998	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	10/19/1994	9/13/2002
Inactive	Humana Insurance Company	301104	Agent - Life	10/19/1994	9/13/2002
Inactive	Medical Life Insurance Company	300693	Agent - Health	12/30/1996	12/31/2004
Inactive	Medical Life Insurance Company	300693	Agent - Life	12/30/1996	12/31/2004
Inactive	Principal Life Insurance Company	300129	Agent - Health	9/8/1994	12/11/2002
Inactive	Principal Life Insurance Company	300129	Agent - Life	9/8/1994	12/11/2002
Inactive	Symetra Life Insurance Company	301691	Agent - Health	5/18/1994	3/31/1997
Inactive	Symetra Life Insurance Company	301691	Agent - Life	5/18/1994	3/31/1997
Inactive	Trustmark Insurance Company	300317	Agent - Health	9/20/1994	12/11/2002
Inactive	Trustmark Insurance Company	300317	Agent - Life	9/20/1994	12/11/2002
Inactive	Union Security Insurance Company	301844	Agent - Health	10/25/1994	12/11/2002
Inactive	Union Security Insurance Company	301844	Agent - Life	10/25/1994	12/11/2002
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	12/10/1998	11/21/2005
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	12/10/1998	11/21/2005
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/1/2001	11/21/2005
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	12/10/1998	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 - Health	9/15/1999	6/23/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	9/15/1999	6/23/2008
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Inactive	Wells Fargo Insurance Services Of Kentucky Inc	399414	Agent - Health	3/24/1992	2/1/2005
Inactive	Wells Fargo Insurance Services Of Kentucky Inc	399414	Agent - Life	3/24/1992	2/1/2005