DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Hazzard Jr, Charles William	DOIID	390743	NAIC NPN	1898036

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	4/24/1992	7/1/1998
Inactive	Resident	Agent	Health Maintenance Organization	7/12/1989	3/31/1997
Inactive	Resident	Agent	Health	7/12/1989	7/1/1998
* 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 Maintenance Organization	7/12/1989	3/31/1997
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	7/12/1989	7/1/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Health	4/21/1993	7/1/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/21/1993	7/1/1998

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	4/24/1992	7/1/1998
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	4/24/1992	7/1/1998