DEPARTMENT OF INSURANCE

Affiliations

Name	Cully, C Grant	DOIID	380909	NAIC NPN	1746531

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	10/30/1991	9/30/2014
Inactive	Non Resident	Agent	Health Maintenance Organization	10/21/1996	3/1/2001
Inactive	Non Resident	Agent	Health	10/30/1991	9/30/2014
* 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. (PA)	660717	Agent - Health	6/28/2010	9/30/2014
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/28/2010	9/30/2014
Inactive	Aetna Life Insurance Company	301140	Agent - Life	6/28/2010	9/30/2014
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	10/21/1996	3/1/2001
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/11/1996	9/30/2014
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/11/1996	9/30/2014
Inactive	Banner Life Insurance Company	301696	Agent - Life	4/4/2006	11/3/2011
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	8/21/1995	3/31/1997
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	8/21/1995	3/31/1997
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	1/6/2012	8/30/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	1/6/2012	8/30/2013
Inactive	First Colony Life Insurance Company	301179	Agent - Life	10/8/1997	7/14/2004
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	6/15/2009	11/16/2011
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	6/15/2009	11/16/2011
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/6/2012	8/30/2013
Inactive	Humana Insurance Company	301104	Agent - Health	1/6/2012	8/30/2013
Inactive	Humana Insurance Company	301104	Agent - Life	1/6/2012	8/30/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	1/6/2012	8/30/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/6/2012	8/30/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Health	11/27/2006	9/22/2011
Inactive	HumanaDental Insurance Company	301457	Agent - Life	11/27/2006	9/22/2011
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/6/2012	8/30/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/6/2012	8/30/2013
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	3/12/2003	12/11/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	3/12/2003	12/11/2012
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	11/16/2007	5/3/2013
Inactive	Optum Insurance of Ohio, Inc	301226	Agent - Health	10/30/1991	12/31/1998
Inactive	Optum Insurance of Ohio, Inc	301226	Agent - Life	10/30/1991	12/31/1998
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	8/4/2009	9/30/2014
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	8/4/2009	9/30/2014
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Health	2/19/2008	8/22/2011
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Life	2/19/2008	8/22/2011
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	8/4/2009	9/30/2014
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	8/4/2009	9/30/2014
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	11/16/2007	5/3/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	11/16/2007	5/3/2013
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/9/2004	12/14/2009
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	6/9/2004	12/14/2009
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/1/2001	12/14/2009
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	7/17/2000	3/1/2001
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	6/9/2004	12/14/2009

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	6/10/1996	2/28/2007
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/10/1996	2/28/2007
Inactive	Benefits Network Insurance Agency Inc	514441	Agent - Life	6/22/2004	9/30/2014
Inactive	Benefits Network Insurance Agency Inc	514441	Agent - Health	6/22/2004	9/30/2014
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	7/22/2004	1/10/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/6/2013	9/30/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/6/2013	9/30/2014
Inactive	Medlink Inc	400721	Agent - Life	9/24/2002	9/30/2014
Inactive	Medlink Inc	400721	Agent - Health	9/24/2002	9/30/2014