DEPARTMENT OF INSURANCE

Affiliations

Name	Green, David A	DOIID	374617	NAIC NPN	1495055

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/23/2023		2/28/2026
Active	Non Resident	Agent	Life	10/23/2023		2/28/2026
Inactive	Non Resident	Agent	Casualty	6/7/2005	2/28/2018
Inactive	Non Resident	Agent	Property	6/7/2005	2/28/2018
Inactive	Non Resident	Agent	Health Maintenance Organization	1/24/1997	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	Aetna Health Inc.	300694	Agent - Health	6/5/2007	12/31/2007
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007	10/4/2011
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/5/2007	10/4/2011
Inactive	Aetna Life Insurance Company	301140	Agent - Life	6/5/2007	10/4/2011
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	11/29/2007	10/1/2010
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	11/29/2007	10/1/2010
Inactive	Anthem Life Insurance Company	301209	Agent - Health	6/1/2004	11/2/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/1/2004	11/2/2016
Inactive	Banner Life Insurance Company	301696	Agent - Life	5/11/2006	2/28/2018
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	8/30/2013
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	6/18/2008	3/30/2018
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	6/18/2008	3/30/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	8/30/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	1/24/1997	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	8/1/1995	8/30/2013
Inactive	Humana Insurance Company	301104	Agent - Life	8/1/1995	8/30/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/26/2011	4/25/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/26/2011	4/25/2013
Active	Metropolitan Life Insurance Company	301948	Agent - Health	10/30/2023
Active	Metropolitan Life Insurance Company	301948	Agent - Life	10/30/2023
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	10/11/2007	6/5/2015
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	10/11/2007	6/5/2015
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Health	10/11/2007	6/25/2008
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Life	10/11/2007	6/25/2008
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	12/7/2005	1/30/2006
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	12/7/2005	1/30/2006

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	5/28/2004	6/23/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	5/28/2004	6/23/2008
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/29/2008	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/29/2008	11/2/2016
Denied	Maddox Ins Agency Llc	617450	Agent - Property
Denied	Maddox Ins Agency Llc	617450	Agent - Casualty