DEPARTMENT OF INSURANCE

Affiliations

Name	Hyatt Jr, Robert L	DOIID	393631	NAIC NPN	66516

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Casualty	8/15/2000	6/11/2014
Inactive	Resident	Agent	Health Maintenance Organization	12/27/1984	3/1/2001
Inactive	Resident	Agent	Health	6/11/1979	6/11/2014
Inactive	Resident	Agent	Property	8/15/2000	6/11/2014
Inactive	Resident	Agent	Life	6/11/1979	6/11/2014
Inactive	Resident	Agent	General Lines	5/4/1982	8/15/2000
AFFIDAVIT ON FILE
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Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	3/9/1994	3/20/1998
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	3/9/1994	3/20/1998
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health	3/1/2001	6/11/2014
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health Maintenance Organization	8/19/1998	3/1/2001
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	8/12/1983	11/15/2006
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	8/12/1983	11/15/2006
Inactive	Consolidated American Insurance Company	301701	Agent - General Lines	12/7/1989	3/31/1996
Inactive	EMC National Life Company	300388	Agent - Life	2/13/1998	4/24/2000
Inactive	Employers Mutual Casualty Company	300202	Agent - General Lines	2/5/1998	4/24/2000
Inactive	Generali - U.S. Branch	301128	Agent - General Lines	5/19/1993	3/31/1998
Inactive	Golden Rule Insurance Company	301943	Agent - Health	6/11/1979	3/31/1997
Inactive	Golden Rule Insurance Company	301943	Agent - Life	6/11/1979	3/31/1997
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	8/15/2000	6/11/2014
Inactive	Grange Indemnity Insurance Company	300793	Agent - General Lines	9/25/1998	8/15/2000
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	8/15/2000	6/11/2014
Inactive	Grange Insurance Company	300234	Agent - Casualty	8/15/2000	6/11/2014
Inactive	Grange Insurance Company	300234	Agent - General Lines	2/7/1996	8/15/2000
Inactive	Grange Insurance Company	300234	Agent - Property	8/15/2000	6/11/2014
Inactive	Grange Life Insurance Company	300128	Agent - Health	2/8/1996	6/11/2014
Inactive	Grange Life Insurance Company	300128	Agent - Life	2/8/1996	6/11/2014
Inactive	Great American Alliance Insurance Company	301247	Agent - General Lines	4/14/1983	3/31/1996
Inactive	Great American Insurance Company	301586	Agent - General Lines	12/7/1982	3/31/1996
Inactive	Great American Insurance Company of New York	301897	Agent - General Lines	12/7/1982	3/31/1996
Inactive	Great Southern Life Insurance Company	301443	Agent - Health	12/31/1979	2/3/2003
Inactive	Great Southern Life Insurance Company	301443	Agent - Life	12/31/1979	2/3/2003
Inactive	Hamilton Mutual Insurance Company	301111	Agent - General Lines	4/27/1993	4/24/2000
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	4/14/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	12/27/1984	3/1/2001
Inactive	Humana Insurance Company	300118	Agent - Health	7/12/1996	12/31/1998
Inactive	Humana Insurance Company	301104	Agent - Health	1/21/2005	4/14/2014
Inactive	Humana Insurance Company	300118	Agent - Life	7/12/1996	12/31/1998
Inactive	Humana Insurance Company	301104	Agent - Life	1/21/2005	4/14/2014
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	4/3/1989	10/3/1996
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	9/2/1997	5/12/2003
Inactive	Old American Indemnity Company	301882	Agent - General Lines	3/29/1983	3/31/1998
Inactive	Philadelphia American Life Insurance Company	300178	Agent - Health	5/17/1995	3/31/1999
Inactive	Philadelphia American Life Insurance Company	300178	Agent - Life	5/17/1995	3/31/1999
Inactive	Progressive Max Insurance Company	301034	Agent - General Lines	4/8/1999	8/15/2000
Inactive	Progressive Northern Insurance Company	301378	Agent - General Lines	4/9/1999	8/15/2000
Inactive	Progressive Northwestern Insurance Company	300441	Agent - General Lines	4/9/1999	8/15/2000
Inactive	RLI Insurance Company	301217	Agent - General Lines	9/12/1998	8/15/2000
Inactive	Security Mutual Life Insurance Company of NY	300708	Agent - Health	12/20/1995	4/18/2007
Inactive	Security Mutual Life Insurance Company of NY	300708	Agent - Life	12/20/1995	4/18/2007
Inactive	South Carolina Insurance Company	300080	Agent - General Lines	11/2/1989	3/31/1998
Inactive	Stonington Insurance Company	300746	Agent - General Lines	7/25/1995	8/15/2000
Inactive	Time Insurance Company	300683	Agent - Health	11/19/1998	2/28/2000
Inactive	Time Insurance Company	300683	Agent - Life	11/19/1998	2/28/2000
Inactive	Titan Indemnity Company	300556	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Titan Indemnity Company	300556	Agent - General Lines	6/8/1990	8/15/2000
Inactive	Titan Indemnity Company	300556	Agent - Property	8/15/2000	3/31/2002
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	8/22/1979	3/31/1997
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	8/22/1979	3/31/1997
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	4/19/1999	11/21/2005
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	4/19/1999	11/21/2005
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/1/2001	11/21/2005
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	2/15/1999	3/1/2001
Inactive	Western Surety Company	300283	Agent - General Lines	3/26/1984	4/24/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Louisville Inc.	401252	Agent - General Lines	7/1/1993	8/15/2000
Inactive	Acordia of Louisville Inc.	401252	Agent - Life	7/1/1993	2/28/2003
Inactive	Acordia of Louisville Inc.	401252	Agent - Health	7/1/1993	2/28/2003
Inactive	Acordia of Louisville Inc.	401252	Agent - Property	8/15/2000	5/31/2003
Inactive	Acordia of Louisville Inc.	401252	Agent - Casualty	8/15/2000	12/10/2001
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Inactive	Ludwig Insurance Agency Inc.	398798	Agent - General Lines	5/4/1982	8/15/2000
Inactive	Ludwig Insurance Agency Inc.	398798	Agent - Life	5/4/1982	2/13/2003
Inactive	Ludwig Insurance Agency Inc.	398798	Agent - Health	5/4/1982	2/13/2003
Inactive	Ludwig Insurance Agency Inc.	398798	Agent - Property	8/15/2000	2/13/2003
Inactive	Ludwig Insurance Agency Inc.	398798	Agent - Casualty	8/15/2000	2/13/2003
Inactive	Medlink Inc	400721	Agent - Life	11/23/1998	6/11/2014
Inactive	Medlink Inc	400721	Agent - Health	11/23/1998	6/11/2014