DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Starks, Jeffrey Allen	DOIID	378778	NAIC NPN	531852

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Administrator	Not Applicable	9/28/2001		2/28/2025
Active	Resident	Agent	Life	1/30/2018		2/28/2025
Active	Resident	Agent	Health	3/1/2001		2/28/2025
Active	Resident	Agent	Casualty	2/19/2020		2/28/2025
Active	Resident	Agent	Property	2/19/2020		2/28/2025
Inactive	Resident	Agent	Health Maintenance Organization	5/5/1994	3/7/2001
* 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	Advantage Care, Inc.	300998	Agent - Health Maintenance Organization	10/10/1996	12/1/2000
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health	3/1/2001	5/25/2017
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health Maintenance Organization	12/12/2000	3/1/2001
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	5/5/1994	3/7/2001

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Baptist Health Plan, Inc. (TPA)	397874	Administrator - Not Applicable	10/8/2001	6/19/2017
Denied	Usi Insurance Services LLC	669260	Agent - Health
Active	Usi Insurance Services LLC	669260	Administrator - Not Applicable	6/7/2017