DEPARTMENT OF INSURANCE

Affiliations

Name	Baptist Health Plan, Inc. (TPA) DBA : Baptist Health Plan	DOIID	397874	NAIC NPN	114178

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Administrator	Not Applicable	9/28/2001	3/31/2019
Inactive	Resident	Agent	Health	8/20/2009	3/31/2019
Inactive	Resident	Agent	Life	8/20/2009	3/31/2019
* 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	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	10/19/2016	3/31/2019
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	12/5/2011	7/21/2016
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	12/5/2011	7/21/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Atkins, Nancy Grosser	327573	Administrator - Not Applicable	9/28/2001	8/31/2012
Inactive	Atkins, Nancy Grosser	327573	Agent - Health	8/20/2009	6/13/2016
Inactive	Atkins, Nancy Grosser	327573	Agent - Life	8/20/2009	5/15/2013
Inactive	Cavender, Leonard L	549069	Agent - Health	9/6/2016	5/31/2017
Inactive	Cavender, Leonard L	549069	Agent - Life	9/6/2016	5/31/2017
Inactive	Cox, Charles Clifford	364672	Administrator - Not Applicable	5/27/2004	1/31/2011
Inactive	Douthat, Amber	877548	Agent - Health	9/25/2015	6/13/2016
Inactive	Fuchs, William D	375383	Administrator - Not Applicable	6/21/1995	3/31/1997
Inactive	Johnson, Marcella Lynn	322224	Agent - Health	8/25/2015	4/20/2016
Inactive	Johnson, Marcella Lynn	322224	Agent - Life	8/25/2015	9/6/2016
Inactive	Kearney, Jessica Dale	549640	Agent - Health	8/20/2009	7/27/2017
Denied	Kearney, Jessica Dale	549640	Agent - Life
Inactive	Keene, James Wesley	604921	Administrator - Not Applicable	8/13/2013	9/13/2016
Inactive	Keene, James Wesley	604921	Agent - Health	8/13/2013	9/6/2016
Inactive	Langefeld, Jessica Elise	536061	Administrator - Not Applicable	6/19/2017	3/31/2019
Inactive	Langefeld, Jessica Elise	536061	Agent - Health	5/31/2017	3/31/2019
Inactive	Langefeld, Jessica Elise	536061	Agent - Life	5/31/2017	3/31/2019
Inactive	Lemons, Deborah Lynn	329220	Agent - Health	5/31/2017	4/13/2018
Inactive	Massa, Fred L	302780	Agent - Health	5/7/2013	10/8/2014
Inactive	Massa, Fred L	302780	Agent - Life	5/7/2013	10/8/2014
Inactive	Ramsey, Garry Rodney	362431	Administrator - Not Applicable	5/30/2003	8/25/2015
Inactive	Ramsey, Garry Rodney	362431	Agent - Health	8/20/2009	8/25/2015
Inactive	Ramsey, Garry Rodney	362431	Agent - Life	8/20/2009	8/25/2015
Inactive	Schaefer, Katherine	321272	Administrator - Not Applicable	6/21/1995	3/31/1999
Inactive	Sisson, William G	324223	Administrator - Not Applicable	6/21/1995	10/30/2003
Inactive	Smith, Tonya Gayle	922799	Agent - Health	6/2/2017	7/6/2017
Inactive	Spurlock, Jo A	304506	Agent - Health	5/31/2017	9/10/2018
Inactive	Starks, Jeffrey Allen	378778	Administrator - Not Applicable	10/8/2001	6/19/2017
Inactive	Williams, Kim Tee	556794	Agent - Health	5/31/2017	1/29/2018
Denied	Williams, Kim Tee	556794	Agent - Life