DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Montgomery, Tracy L	DOIID	387059	NAIC NPN	7207653

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	7/29/1993	7/1/2002
Inactive	Resident	Agent	Life	7/29/1993	7/1/2002
Inactive	Resident	Agent	Health Maintenance Organization	4/20/1998	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	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	4/20/1998	3/1/2001
Inactive	Anthem Life Insurance Company	301209	Agent - Health	7/29/1993	7/1/2002
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/29/1993	7/1/2002
Inactive	Medical Life Insurance Company	300693	Agent - Health	9/12/1998	12/31/2004
Inactive	Medical Life Insurance Company	300693	Agent - Life	9/12/1998	12/31/2004
Inactive	National Travelers Life Company	300304	Agent - Health	5/20/1998	3/11/2002
Inactive	National Travelers Life Company	300304	Agent - Life	5/20/1998	3/11/2002
Inactive	Protective Life Insurance Company	300638	Agent - Health	8/11/1998	7/1/2002
Inactive	Protective Life Insurance Company	300638	Agent - Life	8/11/1998	7/1/2002

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	4/14/1994	7/1/2002
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	4/14/1994	7/1/2002