DEPARTMENT OF INSURANCE
Affiliations
NameMayberry Jr, Charles EDOIID391014NAIC NPN829466
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth10/25/1994 2/28/2025
ActiveNon ResidentAgentLife10/25/1994 2/28/2025
InactiveNon ResidentAgentHealth Maintenance Organization6/9/19953/1/2001 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent12/15/202402/28/2025   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveACE Property and Casualty Insurance Company300520Agent - Health12/22/2022 
ActiveAetna Health Inc. (PA)660717Agent - Health8/13/2018 
ActiveAetna Health and Life Insurance Company300523Agent - Health8/22/2017 
ActiveAetna Health of Ohio Inc.1065035Agent - Health8/6/2020 
ActiveAetna Life Insurance Company301140Agent - Health8/13/2018 
ActiveAetna Life Insurance Company301140Agent - Life8/13/2018 
InactiveAmerican Continental Insurance Company643130Agent - Life8/22/201712/6/2021
InactiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health3/1/20014/1/2002
InactiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health Maintenance Organization6/9/19953/1/2001
ActiveAnthem Health Plans of New Hampshire, Inc.944064Agent - Health9/23/2021 
ActiveAnthem Insurance Companies, Inc.300941Agent - Health9/23/2021 
ActiveAnthem Life Insurance Company301209Agent - Health4/5/1995 
ActiveAnthem Life Insurance Company301209Agent - Life4/5/1995 
ActiveArcadian Health Plan, Inc.728196Agent - Health10/25/2021 
ActiveBanner Life Insurance Company301696Agent - Life5/15/2013 
ActiveCIGNA Health & Life Insurance Company301783Agent - Health7/17/2022 
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health7/21/2022 
ActiveCareSource Kentucky Co.838179Agent - Health11/1/2019 
InactiveCentral States Indemnity Company of Omaha300285Agent - Health3/9/201612/15/2017
InactiveCompBenefits Dental, Inc.591692Agent - Health11/12/20133/14/2019
ActiveCompcare Health Services Insurance Corporation948751Agent - Health9/16/2021 
InactiveContinental Casualty Company301019Agent - Health10/30/199711/29/2004
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health8/22/2017 
ActiveDental Concern Inc. (The)301641Agent - Health4/15/2021 
ActiveFirst Health Life & Health Insurance Company301735Agent - Health8/13/2018 
InactiveGPM Health and Life Insurance Company927255Agent - Health9/7/20208/23/2021
InactiveGolden Rule Insurance Company301943Agent - Health1/11/201712/13/2018
InactiveGolden Rule Insurance Company301943Agent - Life1/11/201712/14/2018
InactiveGuarantee Life Insurance Company301560Agent - Health10/25/19949/8/2000
InactiveGuarantee Life Insurance Company301560Agent - Life10/25/19949/8/2000
ActiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health12/19/2023 
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health11/21/20132/23/2018
ActiveHumana Health Plan, Inc.300142Agent - Health5/4/2020 
InactiveHumana Health Plan, Inc.300142Agent - Health Maintenance Organization8/14/19973/1/2001
ActiveHumana Insurance Company301104Agent - Health4/2/2020 
InactiveHumana Insurance Company301104Agent - Life11/12/201312/19/2019
InactiveHumana Insurance Company of Kentucky300826Agent - Health11/12/20134/8/2020
InactiveHumana Insurance Company of Kentucky300826Agent - Life5/4/202012/15/2020
InactiveHumana Medical Plan, Inc.801568Agent - Health10/13/201412/19/2019
InactiveHumana Wisconsin Health Organization Insurance Corporation830687Agent - Health10/12/201612/19/2019
InactiveJefferson Pilot Financial Insurance Company300756Agent - Health9/8/20007/2/2007
InactiveJefferson Pilot Financial Insurance Company300756Agent - Life9/8/20007/2/2007
InactiveKanawha Insurance Company300127Agent - Health11/12/201310/22/2015
InactiveKanawha Insurance Company300127Agent - Life11/12/201310/22/2015
InactiveLasso Healthcare Insurance Company1022651Agent - Health10/20/20206/23/2023
InactiveLincoln National Life Insurance Company (The)301382Agent - Health7/2/20073/24/2009
InactiveLincoln National Life Insurance Company (The)301382Agent - Life7/2/20073/24/2009
ActiveManhattanLife Insurance and Annuity Company301795Agent - Health12/23/2020 
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Health4/25/20165/16/2018
InactiveMetropolitan Life Insurance Company301948Agent - Health3/24/20054/27/2018
InactiveMetropolitan Life Insurance Company301948Agent - Life3/24/20051/26/2018
InactiveMutual of Omaha Insurance Company301012Agent - Health6/21/20079/30/2012
ActiveNorth River Insurance Company (The)301739Agent - Health4/16/2021 
InactivePrincipal Life Insurance Company300129Agent - Health11/22/199411/30/2003
InactivePrincipal Life Insurance Company300129Agent - Life11/22/199411/30/2003
InactiveProvident Life and Accident Insurance Company301525Agent - Health1/11/19969/9/2015
InactiveProvident Life and Accident Insurance Company301525Agent - Life1/11/19969/9/2015
InactiveReassure America Life Insurance Company301902Agent - Health8/31/19951/2/2003
InactiveReassure America Life Insurance Company301902Agent - Life8/31/19951/2/2003
ActiveSilverScript Insurance Company663526Agent - Health11/6/2016 
InactiveStandard Insurance Company300185Agent - Health10/22/200912/5/2022
InactiveStandard Insurance Company300185Agent - Life10/22/200912/5/2022
ActiveTier One Insurance Company301056Agent - Health10/24/2022 
ActiveTier One Insurance Company301056Agent - Life10/5/2022 
InactiveTime Insurance Company300683Agent - Health11/5/201312/20/2014
InactiveTime Insurance Company300683Agent - Life11/5/201312/20/2014
InactiveUnited World Life Insurance Company300532Agent - Health6/21/200712/15/2010
ActiveUnited of Omaha Life Insurance Company300156Agent - Health12/1/2020 
ActiveUnited of Omaha Life Insurance Company300156Agent - Life12/1/2020 
ActiveUnitedHealthcare Insurance Company300946Agent - Health12/8/2020 
InactiveUnitedHealthcare Insurance Company300946Agent - Life12/9/200511/30/2016
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health12/8/202012/22/2022
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health12/8/202012/23/2021
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health12/9/200511/30/2016
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health12/8/2020 
ActiveWellCare Health Insurance Company of Kentucky, Inc.301478Agent - Health7/25/2019 
ActiveWellCare Health Plans of Kentucky, Inc.838592Agent - Health2/10/2023 
ActiveWellCare Prescription Insurance Inc.654329Agent - Health11/19/2018 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAcordia of Louisville Inc.401252Agent - Life4/18/19952/28/2003
InactiveAcordia of Louisville Inc.401252Agent - Health4/18/19952/28/2003
InactiveArison Insurance Services, Inc.401001Agent - Life11/30/19986/23/2008
InactiveArison Insurance Services, Inc.401001Agent - Health11/30/19986/23/2008
ActiveCallistus Smith Agency, Inc.515578Agent - Life10/13/2003 
ActiveCallistus Smith Agency, Inc.515578Agent - Health10/13/2003 
ActiveDesignated Agent Company Inc.681257Agent - Life6/24/2008 
ActiveDesignated Agent Company Inc.681257Agent - Health6/24/2008 
InactiveHealthplan Services, Inc.401230Agent - Health8/31/19953/31/1997
InactiveMedlink Inc400721Agent - Life9/27/20183/31/2024
InactiveMedlink Inc400721Agent - Health9/27/20183/31/2024

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