DEPARTMENT OF INSURANCE

Affiliations

Name	Gustafson, Stephen Shane	DOIID	389104	NAIC NPN	1589227

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	4/2/1999	3/31/2002
Active	Non Resident	Agent	Health	8/7/2019		4/30/2025
Active	Non Resident	Agent	Life	6/18/2021		4/30/2025
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	12/31/1997	12/31/1998
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	02/15/2025	04/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	10/4/2022	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	10/4/2022
Active	Aetna Health Inc. (PA)	660717	Agent - Health	8/30/2022
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	10/4/2022
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/30/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	8/30/2022
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	5/8/2023
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	5/8/2023
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	5/8/2023
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/11/2017	4/12/2018
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	11/13/2019
Active	Chesapeake Life Insurance Company (The)	301017	Agent - Health	9/19/2022
Active	Chesapeake Life Insurance Company (The)	301017	Agent - Life	9/19/2022
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/14/2014	4/12/2018
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	5/8/2023
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	10/4/2022
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	10/4/2022
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/14/2014	4/12/2018
Inactive	GPM Health and Life Insurance Company	927255	Agent - Health	1/5/2021	9/15/2022
Active	Golden Rule Insurance Company	301943	Agent - Health	5/4/2022
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	4/12/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	8/14/2014	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/14/2014	4/12/2018
Inactive	Humana Insurance Company	301104	Agent - Health	8/14/2014	4/12/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/14/2014	4/12/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	4/12/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	4/12/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/14/2014	10/22/2015
Active	SilverScript Insurance Company	663526	Agent - Health	8/30/2022
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	8/27/2018	4/30/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/10/2020	2/10/2021
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/10/2020	2/10/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/10/2020	2/10/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/10/2020	2/10/2021
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	9/20/2020	12/29/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	9/19/2020	12/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Gallagher Benefit Services Inc	525782	Agent - Health	9/3/2024
Active	Gallagher Benefit Services Inc	525782	Agent - Life	9/3/2024
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	4/6/2015	4/11/2018
Inactive	St. Paul Fire and Marine Insurance Company	300782	Adjuster - Independent	4/2/1999	11/4/1999
Inactive	United Services Automobile Association	300158	Adjuster - Independent	10/13/2000	4/23/2001