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DEPARTMENT OF INSURANCE
Affiliations
Name
Medben Marketing Services Inc.
DOIID
398697
NAIC NPN
2677570
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Active
Non Resident
Agent
Life
12/11/1997
3/31/2027
Active
Non Resident
Agent
Health
12/11/1997
3/31/2027
* If a status Is
Pending, Pending Replacement
,Or the record displays
Affidavit On File
, click On them For more details.
License Renewal Information
Class
Invoice Date
Response Due / Expiration Date
Response Received Date
Payment Received Date
Renewal Complete
Agent
01/15/2025
03/31/2025
01/31/2025
01/31/2025
Yes
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
3/3/2003
4/14/2005
Inactive
American Family Life Assurance Company of Columbus (AFLAC)
301781
Agent - Life
3/3/2003
4/14/2005
Inactive
American Fidelity Assurance Company
301004
Agent - Health
8/8/2007
8/16/2010
Inactive
American Fidelity Assurance Company
301004
Agent - Life
8/8/2007
8/16/2010
Inactive
American General Life Insurance Company of Delaware
301057
Agent - Health
12/10/1998
2/6/2003
Inactive
American General Life Insurance Company of Delaware
301057
Agent - Life
12/10/1998
2/6/2003
Inactive
American Heritage Life Insurance Company
300272
Agent - Health
4/8/2003
3/24/2009
Inactive
American Heritage Life Insurance Company
300272
Agent - Life
4/8/2003
3/24/2009
Active
Arch Insurance Company
300688
Agent - Health
5/27/2003
Inactive
Avemco Insurance Company
300669
Agent - Health
12/7/2000
6/15/2005
Inactive
Berkley Life and Health Insurance Company
301421
Agent - Health
1/25/2011
3/18/2019
Inactive
Canada Life Assurance Company
301192
Agent - Health
5/23/2007
2/5/2009
Inactive
Canada Life Assurance Company
301192
Agent - Life
5/23/2007
2/5/2009
Active
Colonial Life and Accident Insurance Company
300846
Agent - Health
4/7/2005
Active
Colonial Life and Accident Insurance Company
300846
Agent - Life
4/7/2005
Inactive
CompBenefits Dental, Inc.
591692
Agent - Health
1/4/2005
9/9/2010
Inactive
CompBenefits Insurance Company
301864
Agent - Health
1/4/2005
9/9/2010
Inactive
CompBenefits Insurance Company
301864
Agent - Life
1/4/2005
9/9/2010
Inactive
Continental Insurance Company (The)
301242
Agent - Health
12/27/2000
11/10/2003
Inactive
Dental Concern Inc. (The)
301641
Agent - Health
6/21/2010
9/9/2010
Inactive
First Allmerica Financial Life Insurance Company
301853
Agent - Health
12/11/1997
6/4/2006
Inactive
First Allmerica Financial Life Insurance Company
301853
Agent - Life
12/11/1997
6/4/2006
Inactive
Gerber Life Insurance Company
300529
Agent - Health
7/28/2003
12/21/2004
Inactive
Gerber Life Insurance Company
300529
Agent - Life
7/28/2003
12/21/2004
Active
HCC Life Insurance Company
301827
Agent - Health
7/17/2000
Active
HCC Life Insurance Company
301827
Agent - Life
7/17/2000
Active
HM Life Insurance Company
301408
Agent - Health
11/19/2010
Active
HM Life Insurance Company
301408
Agent - Life
11/19/2010
Inactive
Hartford Life Group Insurance Company
301708
Agent - Health
4/6/2004
12/31/2006
Inactive
Hartford Life Group Insurance Company
301708
Agent - Life
4/6/2004
12/31/2006
Active
Hartford Life and Accident Insurance Company
300878
Agent - Health
2/16/2001
Active
Hartford Life and Accident Insurance Company
300878
Agent - Life
2/16/2001
Inactive
Humana Health Plan, Inc.
300142
Agent - Health
3/14/2008
9/9/2010
Inactive
Humana Insurance Company
301104
Agent - Health
3/14/2008
9/9/2010
Inactive
Humana Insurance Company
301104
Agent - Life
3/14/2008
9/9/2010
Inactive
HumanaDental Insurance Company
301457
Agent - Health
3/14/2008
9/9/2010
Inactive
HumanaDental Insurance Company
301457
Agent - Life
3/14/2008
9/9/2010
Inactive
Mutual of Omaha Insurance Company
301012
Agent - Health
8/27/2003
4/18/2013
Active
National Union Fire Insurance Company of Pittsburgh, Pennsylvania
300959
Agent - Health
10/2/2012
Active
Nationwide Life Insurance Company
300495
Agent - Health
10/19/2009
Active
Nationwide Life Insurance Company
300495
Agent - Life
10/19/2009
Inactive
Professional Insurance Company
301281
Agent - Health
7/13/2004
6/21/2006
Inactive
Professional Insurance Company
301281
Agent - Life
7/13/2004
6/21/2006
Inactive
Protective Life Insurance Company
300638
Agent - Health
8/28/2000
12/15/2003
Inactive
Protective Life Insurance Company
300638
Agent - Life
8/28/2000
12/15/2003
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Health
9/24/2001
11/10/2004
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Life
9/24/2001
11/10/2004
Inactive
QBE Insurance Corporation
300515
Agent - Health
1/12/2004
9/29/2021
Active
ReliaStar Life Insurance Company
301712
Agent - Health
7/30/2014
Active
ReliaStar Life Insurance Company
301712
Agent - Life
7/30/2014
Active
Standard Insurance Company
300185
Agent - Health
12/8/2004
Active
Standard Insurance Company
300185
Agent - Life
12/8/2004
Active
Sun Life Assurance Company of Canada
301811
Agent - Health
3/18/2009
Active
Sun Life Assurance Company of Canada
301811
Agent - Life
3/18/2009
Inactive
Sun Life and Health Insurance Company (U.S.)
300801
Agent - Health
3/16/2009
8/22/2011
Inactive
Sun Life and Health Insurance Company (U.S.)
300801
Agent - Life
3/16/2009
8/22/2011
Active
Swiss Re Corporate Solutions America Insurance Corporation
300338
Agent - Health
5/11/2021
Active
Symetra Life Insurance Company
301691
Agent - Health
2/11/2011
Active
Symetra Life Insurance Company
301691
Agent - Life
2/11/2011
Active
Talcott Resolution Life Insurance Company
301759
Agent - Health
10/10/2002
Active
Talcott Resolution Life Insurance Company
301759
Agent - Life
10/10/2002
Inactive
UNUM Life Insurance Company of America
300817
Agent - Health
12/5/1998
12/30/2009
Inactive
UNUM Life Insurance Company of America
300817
Agent - Life
12/5/1998
12/30/2009
Inactive
Union Security Insurance Company
301844
Agent - Health
2/7/2002
1/4/2017
Inactive
Union Security Insurance Company
301844
Agent - Life
2/7/2002
1/4/2017
Active
United States Fire Insurance Company
582240
Agent - Health
11/15/2017
Inactive
United of Omaha Life Insurance Company
300156
Agent - Health
8/27/2003
4/18/2013
Inactive
United of Omaha Life Insurance Company
300156
Agent - Life
8/27/2003
4/18/2013
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Health
7/31/2006
11/30/2016
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Life
7/31/2006
11/30/2016
Inactive
Westport Insurance Corporation
301875
Agent - Health
6/6/2017
4/20/2023
Inactive
Wilcac Life Insurance Company
301573
Agent - Health
8/28/2000
11/10/2003
Inactive
Wilcac Life Insurance Company
301573
Agent - Life
8/28/2000
11/10/2003
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Crum, Michael L
355397
Agent - Health
12/11/1997
9/26/2017
Inactive
Crum, Michael L
355397
Agent - Life
12/11/1997
9/26/2017
Active
Fargus, Brian M
700164
Agent - Health
9/26/2017
Active
Fargus, Brian M
700164
Agent - Life
9/26/2017
Inactive
Pickerill, Blair L
378699
Agent - Health
12/11/1997
8/31/2005
Inactive
Pickerill, Blair L
378699
Agent - Life
12/11/1997
8/31/2005
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