DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Midstates Insurance Services Inc.	DOIID	398889	NAIC NPN	7221245

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	5/31/2001	3/27/2020
Inactive	Resident	Agent	Health	1/4/1994	3/27/2020
* 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	American Benefit Life Insurance Company	301002	Agent - Life	9/6/1990	6/12/1998
Inactive	American Republic Insurance Company	300861	Agent - Health	5/4/1995	3/22/1999
Inactive	American Republic Insurance Company	300861	Agent - Life	5/4/1995	3/22/1999
Inactive	Bankers United Life Assurance Company	300296	Agent - Health	1/4/1994	12/31/2001
Inactive	Bankers United Life Assurance Company	300296	Agent - Life	1/4/1994	12/31/2001
Inactive	First Colony Life Insurance Company	301179	Agent - Life	8/15/1990	3/31/1997
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	8/30/1990	5/20/1999
Inactive	John Alden Life Insurance Company	300573	Agent - Health	3/4/1991	3/31/1997
Inactive	John Alden Life Insurance Company	300573	Agent - Life	3/4/1991	3/31/1997
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	12/31/2001	6/30/2005
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	12/31/2001	5/6/2005

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	3/1/2001	12/31/2001
Inactive	Dental Choice Agency Inc.	398085	Agent - Prepaid Dental Plan	8/9/1999	3/1/2001
Inactive	Hoehn, Wayne Charles	317727	Agent - Health	8/24/2006	3/1/2020
Inactive	Hoehn, Wayne Charles	317727	Agent - Life	8/24/2006	3/1/2020
Inactive	Rickman, Murrell D	351683	Agent - Health	3/26/1991	2/19/2003
Inactive	Rickman, Murrell D	351683	Agent - Life	3/26/1991	2/19/2003
Inactive	West Kentucky Group Benefits	401049	Agent - Health	1/21/1992	12/31/2001
Inactive	West Kentucky Group Benefits	401049	Agent - Life	1/21/1992	12/31/2001