DEPARTMENT OF INSURANCE

Affiliations

Name	Self Funding & Risk Management Solutions LLC	DOIID	395832	NAIC NPN	4403147

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Administrator	Not Applicable	12/11/1998	3/31/2001
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hayes, Kenton Rogers	391241	Administrator - Not Applicable	12/11/1998	3/31/2001
Inactive	Inmon, Mark D	384997	Administrator - Not Applicable	12/11/1998	3/31/2001