DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Crockett, Kevin Dewey	DOIID	372921	NAIC NPN	999811

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/1/2001	7/31/2006
Inactive	Non Resident	Agent	Health Maintenance Organization	11/6/1997	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
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/16/2002	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	11/6/1997	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	Medlink Inc	400721	Agent - Health	5/16/2002	11/21/2005