DEPARTMENT OF INSURANCE
Affiliations
NameBenjamin, Dorine MDOIID382200NAIC NPN5950585
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAdministratorNot Applicable5/7/19998/22/2012 
InactiveResidentAgentHealth Maintenance Organization7/1/19983/1/2001 
InactiveResidentAgentHealth10/24/199711/1/2016 
InactiveResidentAgentLife10/24/199711/1/2016 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAmerican Fidelity Assurance Company301004Agent - Health8/5/20043/7/2005
InactiveAmerican Fidelity Assurance Company301004Agent - Life8/5/20043/7/2005
InactiveAmeritas Life Insurance Corporation300126Agent - Health11/25/200312/28/2012
InactiveAmeritas Life Insurance Corporation300126Agent - Life11/25/200312/28/2012
InactiveBaltimore Life Insurance Company300286Agent - Health12/11/200111/23/2004
InactiveBaltimore Life Insurance Company300286Agent - Life12/11/200111/23/2004
InactiveChase Insurance Life and Annuity Company300518Agent - Health6/26/20024/1/2007
InactiveChase Insurance Life and Annuity Company300518Agent - Life6/26/20024/1/2007
InactiveCitizens Security Life Insurance Company301257Agent - Health5/22/200811/1/2016
InactiveCompBenefits Dental, Inc.591692Agent - Health12/28/201512/13/2016
InactiveCompBenefits Insurance Company301864Agent - Health3/11/20097/2/2013
InactiveCompBenefits Insurance Company301864Agent - Life3/11/20097/2/2013
InactiveCompanion Life Insurance Company300191Agent - Health6/10/199810/18/1999
InactiveCompanion Life Insurance Company300191Agent - Life6/10/199810/18/1999
InactiveDearborn Life Insurance Company300401Agent - Health12/31/200412/30/2013
InactiveDearborn Life Insurance Company300401Agent - Life12/31/200412/30/2013
InactiveDental Concern Inc. (The)301641Agent - Health6/14/200211/1/2016
InactiveFidelity Life Association, A Legal Reserve Life Insurance Company300774Agent - Health6/26/200210/28/2008
InactiveFidelity Life Association, A Legal Reserve Life Insurance Company300774Agent - Life6/26/200210/28/2008
InactiveFort Wayne Health & Casualty Insurance Company301572Agent - Health2/16/200112/22/2004
InactiveHartford Life and Accident Insurance Company300878Agent - Health4/8/200411/16/2011
InactiveHartford Life and Accident Insurance Company300878Agent - Life4/8/200411/16/2011
InactiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health12/28/201512/13/2016
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health12/28/201512/13/2016
InactiveHumana Health Plan, Inc.300142Agent - Health3/1/200111/1/2016
InactiveHumana Health Plan, Inc.300142Agent - Health Maintenance Organization5/19/19993/1/2001
InactiveHumana Insurance Company301104Agent - Health5/19/199911/1/2016
InactiveHumana Insurance Company301104Agent - Life5/19/199911/1/2016
InactiveHumana Insurance Company of Kentucky300826Agent - Health1/29/200411/1/2016
InactiveHumana Insurance Company of Kentucky300826Agent - Life1/29/200411/1/2016
InactiveHumana Medical Plan, Inc.801568Agent - Health12/28/201512/13/2016
InactiveHumanaDental Insurance Company301457Agent - Health10/18/20015/13/2013
InactiveKanawha Insurance Company300127Agent - Health4/11/200810/22/2015
InactiveKanawha Insurance Company300127Agent - Life4/11/200810/22/2015
InactiveLafayette Life Insurance Company (The)301039Agent - Health7/23/19997/31/2009
InactiveLafayette Life Insurance Company (The)301039Agent - Life7/23/19997/31/2009
InactiveLincoln National Life Insurance Company (The)301382Agent - Health12/29/200811/16/2016
InactiveLincoln National Life Insurance Company (The)301382Agent - Life12/29/200811/16/2016
InactiveLincoln National Reassurance Company301919Agent - Health2/16/20011/6/2003
InactiveLincoln National Reassurance Company301919Agent - Life2/16/20011/6/2003
InactiveMedical Life Insurance Company300693Agent - Health3/23/199912/31/2004
InactiveMedical Life Insurance Company300693Agent - Life3/23/199912/31/2004
InactiveMetropolitan Life Insurance Company301948Agent - Health6/3/199811/4/2009
InactiveMetropolitan Life Insurance Company301948Agent - Life6/3/199811/4/2009
InactivePacific Life & Annuity Company300443Agent - Health2/5/20015/4/2006
InactivePacific Life & Annuity Company300443Agent - Life2/5/20015/4/2006
InactiveProfessional Insurance Company301281Agent - Health2/26/20016/20/2006
InactiveProfessional Insurance Company301281Agent - Life2/26/20016/20/2006
InactiveProtective Life Insurance Company300638Agent - Health4/1/200712/16/2010
InactiveProtective Life Insurance Company300638Agent - Life4/1/200712/16/2010
InactiveReassure America Life Insurance Company301902Agent - Health10/24/19971/3/2003
InactiveReassure America Life Insurance Company301902Agent - Life10/24/19971/3/2003
InactiveShenandoah Life Insurance Company300130Agent - Health5/26/20009/30/2005
InactiveShenandoah Life Insurance Company300130Agent - Life5/26/20009/30/2005
InactiveStandard Security Life Insurance Company of NY301487Agent - Life4/22/20021/11/2010
InactiveSun Life and Health Insurance Company (U.S.)300801Agent - Health10/15/20017/7/2004
InactiveSun Life and Health Insurance Company (U.S.)300801Agent - Life10/15/20017/7/2004
InactiveSwiss Re Life & Health America, Inc.300722Agent - Health1/6/200312/22/2004
InactiveSwiss Re Life & Health America, Inc.300722Agent - Life1/6/200312/22/2004
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Health12/2/201011/30/2016
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life12/2/201011/30/2016
InactiveTime Insurance Company300683Agent - Health8/5/20031/27/2005
InactiveTime Insurance Company300683Agent - Life8/5/20031/27/2005
InactiveUnion Security Insurance Company301844Agent - Health9/30/200311/1/2016
InactiveUnion Security Insurance Company301844Agent - Life9/30/200311/1/2016
InactiveUnited Concordia Dental Plans of Kentucky Inc.301923Agent - Health6/12/200111/1/2016
InactiveUnited Concordia Life and Health Insurance Company301220Agent - Health6/12/200111/1/2016
InactiveUnitedHealthcare Insurance Company300946Agent - Health4/16/199812/14/2009
InactiveUnitedHealthcare Insurance Company300946Agent - Life4/16/199812/14/2009
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health3/1/200112/14/2009
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health Maintenance Organization7/1/19983/1/2001
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveCumberland Valley Insurance Mgmt Inc.401247Administrator - Not Applicable5/7/19998/22/2012
InactiveCumberland Valley Insurance Mgmt Inc.401247Agent - Life10/22/20011/7/2016
InactiveCumberland Valley Insurance Mgmt Inc.401247Agent - Health10/22/20011/7/2016
InactiveDental Choice Agency Inc.398085Agent - Health5/7/200211/1/2016
InactiveDesignated Agent Company Inc.681257Agent - Life12/2/20131/28/2016
InactiveDesignated Agent Company Inc.681257Agent - Health12/2/20131/28/2016

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