DEPARTMENT OF INSURANCE

Affiliations

Name	Triple J Benefits Inc.	DOIID	398959	NAIC NPN	7221302

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	7/27/1995	1/1/2015
Inactive	Resident	Agent	Life	7/27/1995	1/1/2015
Inactive	Resident	Agent	Prepaid Dental Plan	11/13/2000	3/1/2001
* 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 Bankers Life Assurance Company of Florida	300171	Agent - Health	6/22/1999	2/13/2008
Inactive	American Bankers Life Assurance Company of Florida	300171	Agent - Life	6/22/1999	2/13/2008
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	8/14/1999	6/26/2000
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	4/2/2001	8/2/2006
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health	8/16/2001	1/1/2015
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	7/27/1995	1/1/2015
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	7/27/1995	1/1/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	12/19/2009
Inactive	DentiCare, Inc.	300655	Agent - Health	3/1/2001	11/1/2005
Inactive	DentiCare, Inc.	300655	Agent - Prepaid Dental Plan	11/13/2000	3/1/2001
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/12/2010	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Health	1/12/2010	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Life	1/12/2010	7/10/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/12/2010	4/25/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/12/2010	4/25/2013
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	3/6/1998	11/18/2008
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	3/6/1998	11/18/2008
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	10/26/2000	12/11/2002
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	10/26/2000	12/11/2002
Inactive	Protective Life Insurance Company	300638	Agent - Health	3/6/2000	12/13/2010
Inactive	Protective Life Insurance Company	300638	Agent - Life	3/6/2000	12/13/2010
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/26/2000	12/30/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/26/2000	12/30/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	9/22/1997	12/30/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	9/22/1997	12/30/2009
Inactive	Union Security Insurance Company	301844	Agent - Health	10/7/1998	1/9/2015
Inactive	Union Security Insurance Company	301844	Agent - Life	10/7/1998	1/9/2015

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Caudill, Brenda G	374559	Agent - Health	7/27/1995	6/30/2006
Inactive	Caudill, Brenda G	374559	Agent - Life	7/27/1995	6/30/2006
Inactive	Caudill, James Edward	371320	Agent - Health	11/14/2008	11/1/2014
Inactive	Caudill, James Edward	371320	Agent - Life	6/24/1998	11/1/2014
Inactive	Hatchett, Frank Rice	339587	Agent - Health	6/28/2002	2/17/2003
Inactive	Hatchett, Frank Rice	339587	Agent - Life	6/28/2002	2/17/2003