DEPARTMENT OF INSURANCE

Affiliations

Name	Burris, W Michael	DOIID	374405	NAIC NPN	252696

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health Maintenance Organization	11/1/1988	3/1/2001
Inactive	Resident	Agent	Life	2/8/1982	6/19/2006
Inactive	Resident	Agent	Prepaid Dental Plan	5/17/1999	3/1/2001
Inactive	Resident	Agent	Health	2/8/1982	6/19/2006
* 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	Aetna Life Insurance Company	301140	Agent - Health	4/13/1999	4/18/2006
Inactive	Aetna Life Insurance Company	301140	Agent - Life	4/13/1999	4/18/2006
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	8/28/2000	3/24/2006
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	8/28/2000	3/24/2006
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	2/21/1992	6/19/2006
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	2/21/1992	6/19/2006
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	10/4/1999	5/23/2002
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	10/4/1999	5/23/2002
Inactive	American National Insurance Company	301861	Agent - Health	6/4/1991	2/20/2001
Inactive	American National Insurance Company	301861	Agent - Life	6/4/1991	2/20/2001
Inactive	American United Life Insurance Company	300498	Agent - Health	12/14/1994	5/7/1998
Inactive	American United Life Insurance Company	300498	Agent - Life	12/14/1994	5/7/1998
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	7/21/1999	12/11/2000
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	7/21/1999	12/11/2000
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	11/1/1988	3/1/2001
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/2/1993	6/19/2006
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/2/1993	6/19/2006
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health	10/25/2000	6/19/2006
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	6/27/2001	6/19/2006
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	6/27/2001	6/19/2006
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	9/14/1993	2/10/2003
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	9/14/1993	2/10/2003
Inactive	CHA HMO, Inc.	300662	Agent - Health	2/1/2002	7/5/2005
Inactive	Celtic Insurance Company	300877	Agent - Health	3/6/1995	3/31/1997
Inactive	Celtic Insurance Company	300877	Agent - Life	3/6/1995	3/31/1997
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Health	3/15/1996	3/31/1997
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Life	3/15/1996	3/31/1997
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	11/16/1994	6/19/2006
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	11/16/1994	6/19/2006
Inactive	CompDent Corporation	301387	Agent - Health	3/1/2001	12/23/2004
Inactive	CompDent Corporation	301387	Agent - Prepaid Dental Plan	5/17/1999	3/1/2001
Inactive	Companion Life Insurance Company	300191	Agent - Health	9/24/1997	6/19/2006
Inactive	Companion Life Insurance Company	300191	Agent - Life	9/24/1997	6/19/2006
Inactive	Continental Casualty Company	301019	Agent - Health	6/29/1999	11/29/2004
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/21/2002	4/10/2006
Inactive	DentiCare, Inc.	300655	Agent - Health	9/24/2001	11/1/2005
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	10/17/1995	10/28/1996
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	10/17/1995	10/28/1996
Inactive	General American Life Insurance Company	300280	Agent - Health	5/17/1990	4/21/1999
Inactive	General American Life Insurance Company	300280	Agent - Life	5/17/1990	4/21/1999
Inactive	Golden Rule Insurance Company	301943	Agent - Health	9/23/1983	3/31/1997
Inactive	Golden Rule Insurance Company	301943	Agent - Life	9/23/1983	3/31/1997
Inactive	Guarantee Life Insurance Company	301560	Agent - Health	1/21/1998	9/8/2000
Inactive	Guarantee Life Insurance Company	301560	Agent - Life	1/21/1998	9/8/2000
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	11/4/1993	6/19/2006
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	11/4/1993	6/19/2006
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	4/10/2006
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	12/30/1996	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	1/14/1994	4/10/2006
Inactive	Humana Insurance Company	300118	Agent - Health	12/30/1996	12/31/1998
Inactive	Humana Insurance Company	301104	Agent - Life	1/14/1994	4/10/2006
Inactive	Humana Insurance Company	300118	Agent - Life	12/30/1996	12/31/1998
Inactive	HumanaDental Insurance Company	301457	Agent - Health	10/18/2001	4/10/2006
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	7/12/2004	12/13/2005
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	7/12/2004	12/13/2005
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	9/8/2000	6/19/2006
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	9/8/2000	6/19/2006
Inactive	John Alden Life Insurance Company	300573	Agent - Health	12/29/2003	6/19/2006
Inactive	John Alden Life Insurance Company	300573	Agent - Life	12/29/2003	6/19/2006
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Health	10/7/1999	5/10/2004
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	10/7/1999	5/10/2004
Inactive	Life Insurance Company of North America	300711	Agent - Health	6/24/1988	12/21/1998
Inactive	Life Insurance Company of North America	300711	Agent - Life	6/24/1988	12/21/1998
Inactive	LifeUSA Insurance Company	300386	Agent - Health	8/28/2000	8/2/2002
Inactive	LifeUSA Insurance Company	300386	Agent - Life	8/28/2000	8/2/2002
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	6/17/1986	3/31/1997
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	6/17/1986	3/31/1997
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	10/14/2005	6/19/2006
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	10/14/2005	6/19/2006
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	9/20/2004	6/19/2006
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	9/20/2004	6/19/2006
Inactive	Midland Life Insurance Company (The)	300310	Agent - Health	5/7/1997	3/31/2001
Inactive	Midland Life Insurance Company (The)	300310	Agent - Life	5/7/1997	3/31/2001
Inactive	Midland National Life Insurance Company	300923	Agent - Health	2/25/2000	6/19/2006
Inactive	Midland National Life Insurance Company	300923	Agent - Life	2/25/2000	3/4/2003
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Life	10/16/1995	3/31/1997
Inactive	Pacific Life & Annuity Company	300443	Agent - Health	11/7/1991	12/31/1998
Inactive	Pacific Life & Annuity Company	300443	Agent - Life	11/7/1991	12/31/1998
Inactive	Pan-American Life Insurance Company	301530	Agent - Health	4/1/1991	6/19/2006
Inactive	Pan-American Life Insurance Company	301530	Agent - Life	4/1/1991	6/19/2006
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	5/14/1991	8/24/2000
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	5/14/1991	8/24/2000
Inactive	Principal Life Insurance Company	300129	Agent - Health	3/6/2000	6/19/2006
Inactive	Principal Life Insurance Company	300129	Agent - Life	3/6/2000	6/19/2006
Inactive	Protective Life Insurance Company	300638	Agent - Health	9/24/2001	12/22/2003
Inactive	Protective Life Insurance Company	300638	Agent - Life	9/24/2001	12/22/2003
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	8/17/2004	6/19/2006
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	8/17/2004	6/19/2006
Inactive	Prudential Insurance Company of America	300784	Agent - Life	9/2/1999	6/19/2006
Inactive	SeeChange Health Insurance Company	301115	Agent - Health	1/20/1989	3/31/1997
Inactive	SeeChange Health Insurance Company	301115	Agent - Life	1/20/1989	3/31/1997
Inactive	Time Insurance Company	300683	Agent - Health	11/23/1999	6/19/2006
Inactive	Time Insurance Company	300683	Agent - Life	11/23/1999	6/19/2006
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Life	2/8/1982	8/17/2005
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	2/8/1982	8/17/2005
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	2/8/1982	8/17/2005
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Health	9/20/1999	3/31/2003
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	9/20/1999	3/31/2003
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	8/21/2000	11/10/2004
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	8/21/2000	11/10/2004
Inactive	Union Security Insurance Company	301844	Agent - Health	5/12/2004	6/19/2006
Inactive	Union Security Insurance Company	301844	Agent - Life	5/12/2004	6/19/2006
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	2/4/1998	3/22/2006
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	2/4/1998	3/22/2006
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	6/21/2004	6/19/2006
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	6/21/2004	6/19/2006
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/1/2001	3/22/2006
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	1/13/1998	3/1/2001
Inactive	West Coast Life Insurance Company	301607	Agent - Life	5/15/2001	6/19/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Louisville Inc.	401252	Agent - Health	5/26/1994	5/31/2003
Inactive	Acordia of Louisville Inc.	401252	Agent - Life	5/26/1994	5/31/2003
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	8/30/1999	6/19/2006
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	8/30/1999	6/19/2006
Inactive	Dental Choice Agency Inc.	398085	Agent - Prepaid Dental Plan	11/30/1999	3/1/2001
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	3/1/2001	6/19/2006
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Inactive	Medlink Inc	400721	Agent - Health	11/4/1991	6/19/2006
Inactive	Medlink Inc	400721	Agent - Life	11/4/1991	6/19/2006
Inactive	Michael Burris Agency Inc.	398649	Agent - Health	9/15/1998	6/19/2006
Inactive	Michael Burris Agency Inc.	398649	Agent - Life	9/15/1998	6/19/2006
Inactive	Planchoice Inc.	400482	Agent - Health	3/5/2003	6/19/2006
Inactive	Planchoice Inc.	400482	Agent - Life	3/5/2003	6/19/2006