DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Benefit Partners Inc.	DOIID	399888	NAIC NPN	7222021

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Prepaid Dental Plan	2/26/1996	10/2/2001
Inactive	Resident	Agent	Health	1/18/1996	8/18/2009
Inactive	Resident	Agent	Life	1/18/1996	8/18/2009
* 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	Acacia Life Insurance Company	300375	Agent - Health	11/10/2003	8/18/2009
Inactive	Acacia Life Insurance Company	300375	Agent - Life	11/10/2003	8/18/2009
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	11/10/2003	8/18/2009
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	11/10/2003	8/18/2009
Inactive	Premier Dental Network Inc.	300661	Agent - Prepaid Dental Plan	2/26/1996	2/2/2001
Inactive	Security Life of Denver Insurance Company	300648	Agent - Health	10/1/2004	4/13/2006
Inactive	Security Life of Denver Insurance Company	300648	Agent - Life	10/1/2004	4/13/2006
Inactive	Southland Life Insurance Company	301175	Agent - Health	1/18/1996	10/1/2004
Inactive	Southland Life Insurance Company	301175	Agent - Life	1/18/1996	10/1/2004
Inactive	Union Central Life Insurance Company	300307	Agent - Health	3/12/1996	3/31/1997
Inactive	Union Central Life Insurance Company	300307	Agent - Life	3/12/1996	3/31/1997

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bohannon, Mary Hollace	357337	Agent - Health	3/3/2003	8/17/2009
Inactive	Bohannon, Mary Hollace	357337	Agent - Life	3/3/2003	8/17/2009
Inactive	Eisenback, Candy Lea	388054	Agent - Health	1/18/1996	2/17/2003
Inactive	Eisenback, Candy Lea	388054	Agent - Life	1/18/1996	2/17/2003