DEPARTMENT OF INSURANCE

Affiliations

Name	Collins, Chapin Ford	DOIID	378028	NAIC NPN	549486

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	1/25/1995		10/31/2026
Active	Resident	Agent	Health	1/25/1995		10/31/2026
Active	Resident	Agent	Variable Life and Variable Annuities	5/31/2001		10/31/2026
Active	Resident	Agent	Casualty	8/15/2000		10/31/2026
Active	Resident	Agent	Property	8/15/2000		10/31/2026
Inactive	Resident	Agent	General Lines	2/3/1995	8/15/2000
Inactive	Resident	Agent	Health Maintenance Organization	1/17/1997	3/1/2001
Inactive	Resident	Agent	Prepaid Dental Plan	3/17/2000	3/1/2001
Active	Resident	Life & Health Consultant	Not Applicable	9/7/2012		10/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	ACE American Insurance Company	300625	Agent - General Lines	5/1/1995	10/12/1998
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - General Lines	5/1/1995	10/12/1998
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - General Lines	5/1/1995	10/12/1998
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	4/22/2003	6/27/2011
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Property	4/22/2003	6/27/2011
Inactive	Aetna Health Inc.	300694	Agent - Health	9/11/2002	12/31/2007
Active	Aetna Health Inc. (PA)	660717	Agent - Health	11/8/2023
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	11/8/2023
Active	Aetna Life Insurance Company	301140	Agent - Health	11/8/2023
Inactive	Aetna Life Insurance Company	301140	Agent - Life	9/11/2002	7/27/2022
Inactive	Alexander Hamilton Life Insurance Co. of America	301779	Agent - Health	1/18/2000	8/1/2000
Inactive	Alexander Hamilton Life Insurance Co. of America	301779	Agent - Life	1/18/2000	8/1/2000
Active	All Savers Insurance Company	301940	Agent - Health	7/1/2015
Active	All Savers Insurance Company	301940	Agent - Life	7/1/2015
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	10/27/2009	8/15/2012
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	10/27/2009	8/15/2012
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	10/27/2009	8/15/2012
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Casualty	8/15/2000	8/11/2006
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - General Lines	3/15/1995	8/15/2000
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Property	8/15/2000	8/11/2006
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	12/8/2010	12/12/2011
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	8/30/2022
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	8/30/2022
Active	American General Life Insurance Company	301585	Agent - Health	12/3/2012
Active	American General Life Insurance Company	301585	Agent - Life	12/3/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	7/21/2009	12/31/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	7/21/2009	12/31/2012
Active	American Home Assurance Company	300246	Agent - Casualty	8/15/2000
Inactive	American Home Assurance Company	300246	Agent - General Lines	3/23/1995	8/15/2000
Active	American Home Assurance Company	300246	Agent - Property	8/15/2000
Inactive	American Investors Life Insurance Company, Inc.	301358	Agent - Life	1/12/2009	9/30/2009
Inactive	American National Insurance Company	301861	Agent - Health	9/25/2017	5/26/2021
Active	American National Insurance Company	301861	Agent - Life	9/25/2017
Inactive	American United Life Insurance Company	300498	Agent - Health	1/24/2005	9/29/2023
Inactive	American United Life Insurance Company	300498	Agent - Life	1/24/2005	9/29/2023
Inactive	American and Foreign Insurance Company	301124	Agent - Casualty	4/30/2003	12/31/2004
Inactive	American and Foreign Insurance Company	301124	Agent - Property	4/30/2003	12/31/2004
Active	American-Amicable Life Insurance Co. of Texas	300257	Agent - Life	4/19/2023
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/19/2023
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	11/19/2023
Active	Anthem Life Insurance Company	301209	Agent - Health	5/31/2017
Active	Anthem Life Insurance Company	301209	Agent - Life	5/31/2017
Inactive	Arrowood Indemnity Company	300144	Agent - Casualty	4/30/2003	2/24/2006
Inactive	Arrowood Indemnity Company	300144	Agent - Property	4/30/2003	2/24/2006
Active	Assurity Life Insurance Company	301099	Agent - Health	8/7/2024
Active	Assurity Life Insurance Company	301099	Agent - Life	8/7/2024
Inactive	Athene Annuity and Life Company	301893	Agent - Life	9/14/2011	2/15/2014
Inactive	Bankers Standard Insurance Company	301620	Agent - General Lines	5/1/1995	10/16/1998
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	7/30/2003	12/21/2011
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	7/30/2003	12/21/2011
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	11/14/2014	1/26/2018
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	10/25/2023
Inactive	Century Indemnity Company	301310	Agent - General Lines	5/1/1995	3/31/1998
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	4/2/1997	4/7/1999
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	11/11/2004	3/21/2006
Active	Cincinnati Casualty Company (The)	300308	Agent - Casualty	4/9/2003
Active	Cincinnati Casualty Company (The)	300308	Agent - Property	4/9/2003
Active	Cincinnati Indemnity Company (The)	301566	Agent - Casualty	4/9/2003
Active	Cincinnati Indemnity Company (The)	301566	Agent - Property	4/9/2003
Active	Cincinnati Insurance Company	301298	Agent - Casualty	4/9/2003
Active	Cincinnati Insurance Company	301298	Agent - Property	4/9/2003
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Health	4/9/2003
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	4/9/2003
Active	Combined Insurance Company of America	301472	Agent - Health	4/8/2009
Active	Combined Insurance Company of America	301472	Agent - Life	4/8/2009
Active	Commerce and Industry Insurance Company	300881	Agent - Casualty	8/15/2000
Inactive	Commerce and Industry Insurance Company	300881	Agent - General Lines	3/23/1995	8/15/2000
Active	Commerce and Industry Insurance Company	300881	Agent - Property	8/15/2000
Inactive	Commercial Insurance Company of Newark, New Jersey	300328	Agent - General Lines	2/4/1997	3/31/1998
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/9/2010	3/14/2019
Active	CompBenefits Insurance Company	301864	Agent - Health	11/1/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Life	11/7/2008	7/2/2013
Inactive	CompDent Corporation	301387	Agent - Health	4/7/2003	12/23/2004
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	12/5/2023
Inactive	Continental American Insurance Company	301700	Agent - Health	12/30/2019	5/7/2022
Inactive	Continental American Insurance Company	301700	Agent - Life	12/30/2019	5/7/2022
Inactive	Continental Casualty Company	301019	Agent - Casualty	8/15/2000	8/11/2006
Inactive	Continental Casualty Company	301019	Agent - General Lines	3/15/1995	8/15/2000
Inactive	Continental Casualty Company	301019	Agent - Property	8/15/2000	8/11/2006
Inactive	Continental General Insurance Company	300691	Agent - Health	8/9/2018	1/25/2019
Inactive	Continental General Insurance Company	300691	Agent - Life	8/9/2018	1/25/2019
Inactive	Continental Insurance Company (The)	301242	Agent - Casualty	2/24/2006	8/11/2006
Inactive	Continental Insurance Company (The)	301242	Agent - General Lines	2/4/1997	3/31/1998
Inactive	Continental Insurance Company (The)	301242	Agent - Property	2/24/2006	8/11/2006
Pending Replacement	Dental Care Plus Inc.	301495	Agent - Health	12/12/2006
Active	Dental Concern Inc. (The)	301641	Agent - Health	6/21/2002
Inactive	DentiCare, Inc.	300655	Agent - Health	3/1/2001	11/1/2005
Inactive	DentiCare, Inc.	300655	Agent - Prepaid Dental Plan	3/17/2000	3/1/2001
Inactive	Employers Insurance Company of Wausau	301813	Agent - Casualty	8/15/2000	4/28/2008
Inactive	Employers Insurance Company of Wausau	301813	Agent - General Lines	3/15/1995	8/15/2000
Inactive	Employers Insurance Company of Wausau	301813	Agent - Property	8/15/2000	4/28/2008
Inactive	Employers' Fire Insurance Company (The)	301255	Agent - General Lines	3/24/1995	3/31/1996
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	5/19/2011	10/3/2024
Inactive	Encompass Indemnity Company	546376	Agent - Property	5/19/2011	10/3/2024
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	1/26/2004	12/13/2018
Inactive	Encompass Insurance Company of America	556578	Agent - Property	1/26/2004	12/13/2018
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	1/1/2009	12/9/2010
Inactive	Equitable Financial Life Insurance Company of America	301772	Agent - Life	3/12/2004	12/18/2018
Inactive	Farmington Casualty Company	301137	Agent - Casualty	5/9/2006	12/12/2016
Inactive	Farmington Casualty Company	301137	Agent - Property	5/9/2006	12/12/2016
Inactive	Federal Insurance Company	301144	Agent - General Lines	2/3/1995	11/5/1999
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	2/14/2023
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	6/14/2011
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	6/14/2011
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - Casualty	8/15/2000	12/27/2001
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - General Lines	2/3/1997	8/15/2000
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - Property	8/15/2000	12/27/2001
Inactive	Fireman's Fund Insurance Company	301423	Agent - General Lines	3/10/1995	3/31/1996
Inactive	Firemen's Insurance Company of Newark, New Jersey	300247	Agent - General Lines	2/5/1997	3/31/1998
Inactive	First Colony Life Insurance Company	301179	Agent - Life	8/29/1995	1/1/2007
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	4/30/2001	1/21/2010
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Variable Life and Variable Annuities	5/31/2001	1/21/2010
Inactive	Genworth Life Insurance Company	300623	Agent - Health	3/6/2003	12/7/2012
Inactive	Genworth Life Insurance Company	300623	Agent - Life	3/6/2003	12/7/2012
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	4/9/2009	12/14/2016
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	12/14/2016
Inactive	Glens Falls Insurance Company (The)	301922	Agent - General Lines	2/4/1997	3/31/1998
Inactive	Globe Indemnity Company	300507	Agent - Casualty	4/30/2003	12/31/2004
Inactive	Globe Indemnity Company	300507	Agent - Property	4/30/2003	12/31/2004
Inactive	Great Northern Insurance Company	301107	Agent - General Lines	2/15/1995	3/31/1998
Active	Guardian Life Insurance Company of America	301316	Agent - Health	7/30/2003
Active	Guardian Life Insurance Company of America	301316	Agent - Life	7/30/2003
Active	HCC Life Insurance Company	301827	Agent - Health	9/27/2017
Inactive	HM Life Insurance Company	301408	Agent - Health	11/18/1999	9/10/2007
Inactive	HM Life Insurance Company	301408	Agent - Life	11/18/1999	9/10/2007
Active	Hartford Fire Insurance Company	300628	Agent - Health	3/8/2021
Inactive	Hartford Life Group Insurance Company	301708	Agent - Health	7/28/2005	12/31/2006
Inactive	Hartford Life Group Insurance Company	301708	Agent - Life	7/28/2005	12/31/2006
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	3/6/2000
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	3/6/2000
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	12/14/2016
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/12/2018
Active	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	1/17/1997	3/1/2001
Active	Humana Insurance Company	301104	Agent - Health	1/25/1995
Active	Humana Insurance Company	301104	Agent - Life	1/25/1995
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	1/29/2004
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	1/29/2004
Active	Humana Medical Plan, Inc.	801568	Agent - Health	12/14/2016
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/14/2016
Inactive	HumanaDental Insurance Company	301457	Agent - Health	10/18/2001	5/13/2013
Inactive	Indemnity Insurance Company of North America	301760	Agent - General Lines	5/1/1995	10/12/1998
Active	Independent Order of Foresters	300743	Agent - Health	9/20/2024
Active	Independent Order of Foresters	300743	Agent - Life	9/20/2024
Inactive	Insurance Company of North America	300226	Agent - General Lines	5/1/1995	10/12/1998
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	1/10/2003	7/2/2007
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	1/10/2003	7/2/2007
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Variable Life and Variable Annuities	1/10/2003	7/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	1/10/2003	4/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	1/10/2003	4/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Variable Life and Variable Annuities	1/10/2003	4/2/2007
Inactive	John Alden Life Insurance Company	300573	Agent - Health	5/10/2007	12/29/2008
Inactive	John Alden Life Insurance Company	300573	Agent - Life	5/10/2007	12/29/2008
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	3/4/2004	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	3/4/2004	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	2/12/2016	12/29/2020
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	2/12/2016	12/29/2020
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Life	9/26/1996	3/31/1997
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	8/9/2018
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	8/9/2018
Inactive	Kansas City Fire and Marine Insurance Company	301936	Agent - Casualty	5/9/2003	12/16/2004
Inactive	Kansas City Fire and Marine Insurance Company	301936	Agent - General Lines	2/4/1997	3/31/1998
Inactive	Kansas City Fire and Marine Insurance Company	301936	Agent - Property	5/9/2003	12/16/2004
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	10/15/2013	10/29/2015
Inactive	Lamorak Insurance Company	301231	Agent - General Lines	3/24/1995	3/31/1996
Active	Life Insurance Company of North America	300711	Agent - Health	3/31/2014
Active	Life Insurance Company of North America	300711	Agent - Life	3/31/2014
Active	Life Insurance Company of the Southwest	301867	Agent - Health	4/17/2023
Active	Life Insurance Company of the Southwest	301867	Agent - Life	4/17/2023
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	3/20/2001	9/11/2002
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	3/20/2001	9/11/2002
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Health	6/15/2016	10/10/2019
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Life	6/15/2016	10/10/2019
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	7/6/2006
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	7/6/2006
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Variable Life and Variable Annuities	3/22/2007
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	12/18/2007	1/7/2010
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	12/6/2010	11/14/2014
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Life	7/20/2004	12/7/2007
Active	Metropolitan Life Insurance Company	301948	Agent - Health	4/26/2013
Active	Metropolitan Life Insurance Company	301948	Agent - Life	4/26/2013
Active	Minnesota Life Insurance Company	300488	Agent - Health	7/31/2018
Active	Minnesota Life Insurance Company	300488	Agent - Life	7/31/2018
Active	Minnesota Life Insurance Company	300488	Agent - Variable Life and Variable Annuities	7/31/2018
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Casualty	8/15/2000	8/11/2006
Inactive	National Fire Insurance Company of Hartford	301063	Agent - General Lines	3/15/1995	8/15/2000
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Property	8/15/2000	8/11/2006
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	5/1/1995	3/31/1999
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	5/1/1995	3/31/1999
Denied	National Health Insurance Company	300554	Agent - Health
Denied	National Health Insurance Company	300554	Agent - Life
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	8/15/2000
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - General Lines	3/23/1995	8/15/2000
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	8/15/2000
Inactive	New England Life Insurance Company	300343	Agent - Health	11/15/2004	12/29/2006
Inactive	New England Life Insurance Company	300343	Agent - Life	11/15/2004	12/29/2006
Active	New York Life Insurance Company	300431	Agent - Health	11/6/2017
Active	New York Life Insurance Company	300431	Agent - Life	11/6/2017
Active	North American Company for Life and Health Insurance	300291	Agent - Life	6/8/2023
Inactive	Northern Assurance Company of America The	301331	Agent - General Lines	3/24/1995	3/31/1996
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Health	8/20/1999	4/12/2002
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Life	8/20/1999	4/12/2002
Inactive	Pacific Employers Insurance Company	301753	Agent - General Lines	5/1/1995	10/12/1998
Inactive	Pacific Indemnity Company	301610	Agent - General Lines	2/15/1995	3/31/1998
Active	Pacific Life Insurance Company	301848	Agent - Life	6/17/2020
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	4/25/1996	8/24/2000
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	4/25/1996	8/24/2000
Inactive	Penn Insurance and Annuity Company	300712	Agent - Life	11/20/2000	4/1/2004
Inactive	Penn Mutual Life Insurance Company	301394	Agent - Life	11/20/2000	4/1/2004
Inactive	Penn Mutual Life Insurance Company	301394	Agent - Variable Life and Variable Annuities	5/31/2001	4/4/2005
Active	Principal Life Insurance Company	300129	Agent - Health	7/21/1997
Active	Principal Life Insurance Company	300129	Agent - Life	7/21/1997
Active	Principal National Life Insurance Company	301926	Agent - Life	2/20/2013
Inactive	Protective Life Insurance Company	300638	Agent - Health	4/5/2016	11/23/2023
Inactive	Protective Life Insurance Company	300638	Agent - Life	4/5/2016	11/23/2023
Inactive	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities	4/5/2016	11/23/2023
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	12/15/1995
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	12/15/1995
Inactive	Pruco Life Insurance Company	300954	Agent - Health	12/14/2004	12/21/2022
Active	Pruco Life Insurance Company	300954	Agent - Life	3/1/2023
Inactive	Prudential Insurance Company of America	300784	Agent - Health	12/1/1998	12/23/2014
Inactive	Prudential Insurance Company of America	300784	Agent - Life	12/1/1998	12/23/2014
Inactive	Reassure America Life Insurance Company	301902	Agent - Health	2/25/1998	9/3/2004
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	2/25/1998	9/3/2004
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	10/1/2003	10/5/2012
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	10/1/2003	10/5/2012
Inactive	Reliance Insurance Company	300785	Agent - Casualty	8/15/2000	6/5/2001
Inactive	Reliance Insurance Company	300785	Agent - General Lines	8/5/1998	8/15/2000
Inactive	Reliance Insurance Company	300785	Agent - Property	8/15/2000	6/5/2001
Inactive	Reliance National Indemnity Company	301939	Agent - General Lines	8/5/1998	8/15/2000
Inactive	Reliance National Insurance Company	301675	Agent - General Lines	10/7/1998	8/15/2000
Inactive	Royal Insurance Company of America	301120	Agent - Casualty	4/30/2003	12/31/2004
Inactive	Royal Insurance Company of America	301120	Agent - Property	4/30/2003	12/31/2004
Inactive	SPARTA Insurance Company	301523	Agent - General Lines	3/24/1995	3/31/1996
Inactive	Safeguard Insurance Company	300800	Agent - Casualty	4/30/2003	12/31/2004
Inactive	Safeguard Insurance Company	300800	Agent - Property	4/30/2003	12/31/2004
Inactive	Security Insurance Company of Hartford	300973	Agent - Casualty	4/30/2003	2/24/2006
Inactive	Security Insurance Company of Hartford	300973	Agent - Property	4/30/2003	2/24/2006
Inactive	Security Life of Denver Insurance Company	300648	Agent - Life	1/27/2011	2/27/2016
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Health	6/14/1995	10/1/2003
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Life	6/14/1995	10/1/2003
Active	SilverScript Insurance Company	663526	Agent - Health	11/8/2023
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	8/15/2000	4/25/2002
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - General Lines	4/4/1995	8/15/2000
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	8/15/2000	4/25/2002
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Casualty	8/15/2000	4/25/2002
Inactive	St. Paul Mercury Insurance Company	300783	Agent - General Lines	4/4/1995	8/15/2000
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Property	8/15/2000	4/25/2002
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	8/15/2000	12/12/2016
Inactive	Standard Fire Insurance Company (The)	301068	Agent - General Lines	2/15/2000	8/15/2000
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	8/15/2000	12/12/2016
Active	Standard Insurance Company	300185	Agent - Health	9/5/2013
Active	Standard Insurance Company	300185	Agent - Life	9/5/2013
Active	Starmount Life Insurance Company	628031	Agent - Health	10/8/2021
Active	State Auto Property & Casualty Insurance Company	301953	Agent - Casualty	5/12/2020
Active	State Auto Property & Casualty Insurance Company	301953	Agent - Property	5/12/2020
Inactive	State Life Insurance Company	301497	Agent - Health	1/9/2011	7/10/2017
Inactive	State Life Insurance Company	301497	Agent - Life	1/9/2011	7/10/2017
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Life	1/9/2001	12/13/2006
Pending Replacement	Superior Dental Care Inc.	300418	Agent - Health	9/2/2014
Active	Symetra Life Insurance Company	301691	Agent - Health	6/6/2024
Active	Symetra Life Insurance Company	301691	Agent - Life	6/6/2024
Active	Symetra Life Insurance Company	301691	Agent - Variable Life and Variable Annuities	6/6/2024
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	4/11/2001	9/27/2016
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	4/11/2001	9/27/2016
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	8/15/2000	12/12/2016
Inactive	The Phoenix Insurance Company	301502	Agent - General Lines	2/15/2000	8/15/2000
Inactive	The Phoenix Insurance Company	301502	Agent - Property	8/15/2000	12/12/2016
Active	The Savings Bank Mutual Life Insurance Company of Massachusetts	690290	Agent - Life	2/27/2023
Inactive	Time Insurance Company	300683	Agent - Health	10/9/2013	11/25/2019
Inactive	Time Insurance Company	300683	Agent - Life	10/9/2013	11/25/2019
Active	Transamerica Life Insurance Company	300571	Agent - Health	11/28/2024
Active	Transamerica Life Insurance Company	300571	Agent - Life	11/28/2024
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Health	9/8/1999	8/26/2005
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Life	9/8/1999	8/26/2005
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	10/2/1995	8/26/2005
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	10/2/1995	8/26/2005
Inactive	Transcontinental Insurance Company	301731	Agent - Casualty	8/15/2000	8/11/2006
Inactive	Transcontinental Insurance Company	301731	Agent - General Lines	3/15/1995	8/15/2000
Inactive	Transcontinental Insurance Company	301731	Agent - Property	8/15/2000	8/11/2006
Inactive	Transportation Insurance Company	301575	Agent - Casualty	8/15/2000	8/11/2006
Inactive	Transportation Insurance Company	301575	Agent - General Lines	3/15/1995	8/15/2000
Inactive	Transportation Insurance Company	301575	Agent - Property	8/15/2000	8/11/2006
Inactive	Travelers Casualty Company of Connecticut	301505	Agent - Casualty	9/3/2002	12/5/2013
Inactive	Travelers Casualty Company of Connecticut	301505	Agent - Property	9/3/2002	12/5/2013
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	5/9/2006	12/12/2016
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	5/9/2006	12/12/2016
Inactive	Travelers Commercial Casualty Company	301695	Agent - Casualty	5/9/2006	8/2/2013
Inactive	Travelers Commercial Casualty Company	301695	Agent - Property	5/9/2006	8/2/2013
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	7/19/2005	12/12/2016
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	7/19/2005	12/12/2016
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	8/15/2000	12/12/2016
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - General Lines	2/15/2000	8/15/2000
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	8/15/2000	12/12/2016
Inactive	Travelers Property Casualty Insurance Company	301508	Agent - Casualty	9/3/2002	12/5/2013
Inactive	Travelers Property Casualty Insurance Company	301508	Agent - Property	9/3/2002	12/5/2013
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	10/31/2002	9/26/2007
Active	UNUM Life Insurance Company of America	300817	Agent - Health	10/28/2009
Active	UNUM Life Insurance Company of America	300817	Agent - Life	10/28/2009
Inactive	Union Central Life Insurance Company	300307	Agent - Health	6/23/2003	7/1/2014
Inactive	Union Central Life Insurance Company	300307	Agent - Life	6/23/2003	7/1/2014
Active	Union Security Insurance Company	301844	Agent - Health	12/15/2017
Active	Union Security Insurance Company	301844	Agent - Life	12/15/2017
Inactive	United Pacific Insurance Company	300538	Agent - General Lines	8/5/1998	8/15/2000
Active	United of Omaha Life Insurance Company	300156	Agent - Health	2/12/2018
Active	United of Omaha Life Insurance Company	300156	Agent - Life	2/12/2018
Active	United of Omaha Life Insurance Company	300156	Agent - Variable Life and Variable Annuities	3/7/2024
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	3/29/2017
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	3/29/2017
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	11/1/2024
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	8/17/1998	3/1/2001
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	11/1/2024
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/25/2023
Active	Unum Insurance Company	301499	Agent - Health	10/8/2021
Active	Unum Insurance Company	301499	Agent - Life	10/8/2021
Inactive	Valley Forge Insurance Company	301052	Agent - Casualty	8/15/2000	8/11/2006
Inactive	Valley Forge Insurance Company	301052	Agent - General Lines	3/15/1995	8/15/2000
Inactive	Valley Forge Insurance Company	301052	Agent - Property	8/15/2000	8/11/2006
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	7/29/2005	8/17/2009
Inactive	Vigilant Insurance Company	301143	Agent - General Lines	2/15/1995	3/31/1998
Active	Vision Service Plan Insurance Company	300526	Agent - Health	5/10/2013
Inactive	Wausau Business Insurance Company	301476	Agent - Casualty	8/15/2000	4/28/2008
Inactive	Wausau Business Insurance Company	301476	Agent - General Lines	3/15/1995	8/15/2000
Inactive	Wausau Business Insurance Company	301476	Agent - Property	8/15/2000	4/28/2008
Inactive	Wausau Underwriters Insurance Company	301105	Agent - Casualty	8/15/2000	4/28/2008
Inactive	Wausau Underwriters Insurance Company	301105	Agent - General Lines	3/15/1995	8/15/2000
Inactive	Wausau Underwriters Insurance Company	301105	Agent - Property	8/15/2000	4/28/2008
Inactive	West Coast Life Insurance Company	301607	Agent - Life	12/2/2003	11/16/2011
Inactive	Western National Life Insurance Company	300461	Agent - Life	11/12/2003	3/20/2007
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Health	4/6/1999	12/19/2002
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Life	4/6/1999	12/19/2002
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Variable Life and Variable Annuities	3/22/2001	12/19/2002
Inactive	Zurich American Life Insurance Company	300216	Agent - Life	4/2/1997	7/13/2011
Inactive		300277	Agent - Life	11/6/2000	12/18/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dental Choice Agency Inc.	398085	Agent - Health	1/7/2002
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/13/2013	2/10/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/13/2013	2/10/2025
Inactive	Harris & Harris of Kentucky Inc.	399470	Agent - General Lines	3/15/1996	8/15/2000
Inactive	Harris & Harris of Kentucky Inc.	399470	Agent - Life	3/15/1996	5/31/2004
Inactive	Harris & Harris of Kentucky Inc.	399470	Agent - Health	3/15/1996	5/31/2004
Inactive	Harris & Harris of Kentucky Inc.	399470	Agent - Property	8/15/2000	5/31/2004
Inactive	Harris & Harris of Kentucky Inc.	399470	Agent - Casualty	8/15/2000	5/31/2004
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Active	Planchoice Inc.	400482	Agent - Health	4/17/2014
Inactive	Sterling G. Thompson Co.	399153	Agent - Life	5/17/2002	12/8/2016
Inactive	Sterling G. Thompson Co.	399153	Agent - Health	5/17/2002	12/8/2016
Inactive	Sterling G. Thompson Co.	399153	Agent - Property	5/17/2002	12/8/2016
Inactive	Sterling G. Thompson Co.	399153	Agent - Casualty	5/17/2002	12/8/2016
Active	Sterling Thompson Company	935239	Agent - Life	11/3/2016
Active	Sterling Thompson Company	935239	Agent - Health	11/3/2016
Active	Sterling Thompson Company	935239	Agent - Property	11/3/2016
Active	Sterling Thompson Company	935239	Agent - Casualty	11/3/2016