DEPARTMENT OF INSURANCE

Affiliations

Name	Group Benefit Associates Inc.	DOIID	400040	NAIC NPN	7222117

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	4/15/1992	3/31/2014
Inactive	Resident	Agent	Life	5/31/2001	3/31/2014
Inactive	Resident	Agent	Health Maintenance Organization	8/26/1987	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	Aetna Health Inc. (PA)	660717	Agent - Health	8/7/2009	2/2/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/7/2009	2/2/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Life	8/7/2009	2/2/2012
Inactive	All American Life Insurance Company	300702	Agent - Health	9/14/1989	3/31/1997
Inactive	All American Life Insurance Company	300702	Agent - Life	9/14/1989	3/31/1997
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	5/15/1996	10/7/2011
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	5/31/2001	10/7/2011
Inactive	American General Life Insurance Company	301585	Agent - Health	1/6/2006	11/9/2012
Inactive	American General Life Insurance Company	301585	Agent - Life	1/6/2006	11/9/2012
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	1/21/1997	12/21/1998
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	1/21/1997	12/21/1998
Inactive	American National Insurance Company	301861	Agent - Life	5/31/2001	3/31/2014
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/1/2001	2/1/2014
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	8/26/1987	3/1/2001
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	12/21/2001	10/16/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/24/1999	2/1/2014
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/31/2001	2/1/2014
Inactive	Bankers National Life Insurance Company	301942	Agent - Health	4/15/1992	10/1/2004
Inactive	Bankers National Life Insurance Company	301942	Agent - Life	5/31/2001	10/1/2004
Inactive	Berkshire Life Insurance Company	301158	Agent - Health	12/6/1999	7/1/2001
Inactive	Berkshire Life Insurance Company	301158	Agent - Life	12/6/1999	7/1/2001
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	7/20/2001	2/21/2003
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	7/20/2001	2/21/2003
Inactive	CHA HMO, Inc.	300662	Agent - Health	6/25/2002	11/17/2004
Inactive	Citizens Security Life Insurance Company	301257	Agent - Health	4/15/1992	12/30/2004
Inactive	Citizens Security Life Insurance Company	301257	Agent - Life	5/31/2001	12/30/2004
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/28/2009	3/31/2014
Inactive	CompBenefits Insurance Company	301864	Agent - Health	7/28/2009	7/2/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	7/28/2009	7/2/2013
Inactive	Dearborn Life Insurance Company	300401	Agent - Health	3/21/1997	5/12/2014
Inactive	Dearborn Life Insurance Company	300401	Agent - Life	5/31/2001	5/12/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	3/31/2014
Inactive	First Colony Life Insurance Company	301179	Agent - Health	1/25/2002	1/1/2007
Inactive	First Colony Life Insurance Company	301179	Agent - Life	1/25/2002	1/1/2007
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	1/1/2007	3/31/2014
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	3/31/2014
Inactive	Golden Rule Insurance Company	301943	Agent - Health	2/26/1991	12/2/2002
Inactive	Golden Rule Insurance Company	301943	Agent - Life	2/26/1991	12/2/2002
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	7/1/2001	4/2/2003
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	7/1/2001	4/2/2003
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	4/25/2008	3/31/2014
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	4/25/2008	3/31/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	3/31/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	3/14/1998	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	6/3/1998	3/31/2014
Inactive	Humana Insurance Company	301104	Agent - Life	5/31/2001	3/31/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/30/2010	3/31/2014
Inactive	HumanaDental Insurance Company	301457	Agent - Health	1/11/2011	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	1/11/2011	2/23/2012
Inactive	IL Annuity and Insurance Company	300772	Agent - Life	7/1/1998	6/30/2003
Inactive	Indianapolis Life Insurance Company	301381	Agent - Life	6/30/2003	4/5/2005
Inactive	Investors Life Insurance Company of North America	301660	Agent - Life	9/23/2005	2/21/2008
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/13/2008	4/25/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/13/2008	4/25/2013
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Health	12/1/1998	5/10/2004
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	12/1/1998	5/10/2004
Inactive	LifeUSA Insurance Company	300386	Agent - Health	5/15/1996	8/2/2002
Inactive	LifeUSA Insurance Company	300386	Agent - Life	5/15/1996	8/2/2002
Inactive	MedAmerica Insurance Company	301568	Agent - Health	3/10/2005	6/23/2010
Inactive	Medical Life Insurance Company	300693	Agent - Health	7/18/2001	12/31/2004
Inactive	Medical Life Insurance Company	300693	Agent - Life	7/18/2001	12/31/2004
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	2/15/2002	12/28/2006
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	2/15/2002	12/28/2006
Inactive	Midland Life Insurance Company (The)	300310	Agent - Health	6/9/1997	3/12/2002
Inactive	Midland Life Insurance Company (The)	300310	Agent - Life	6/9/1997	3/12/2002
Inactive	Midland National Life Insurance Company	300923	Agent - Health	6/6/2008	10/15/2010
Inactive	Midland National Life Insurance Company	300923	Agent - Life	6/6/2008	10/15/2010
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	3/28/2009	12/15/2011
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	11/20/1989	3/31/1999
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	11/20/1989	3/31/1999
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	3/1/2001	8/27/2007
Inactive	Nationwide Life Insurance Company	300495	Agent - Health Maintenance Organization	6/12/1996	3/1/2001
Inactive	Penn Insurance and Annuity Company	300712	Agent - Health	11/9/2006	3/31/2014
Inactive	Penn Insurance and Annuity Company	300712	Agent - Life	11/9/2006	3/31/2014
Inactive	Penn Mutual Life Insurance Company	301394	Agent - Health	4/15/1992	3/31/2014
Inactive	Penn Mutual Life Insurance Company	301394	Agent - Life	5/31/2001	3/31/2014
Inactive	Philadelphia American Life Insurance Company	300178	Agent - Health	5/18/1987	3/31/1999
Inactive	Philadelphia American Life Insurance Company	300178	Agent - Life	5/18/1987	3/31/1999
Inactive	Principal Life Insurance Company	300129	Agent - Health	7/16/2001	3/31/2014
Inactive	Principal Life Insurance Company	300129	Agent - Life	7/16/2001	3/31/2014
Inactive	Protective Life Insurance Company	300638	Agent - Health	1/1/2007	12/21/2010
Inactive	Protective Life Insurance Company	300638	Agent - Life	1/1/2007	12/21/2010
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	5/1/2008	3/31/2014
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	5/1/2008	3/31/2014
Inactive	Reassure America Life Insurance Company	300678	Agent - Health	3/12/2002	9/30/2007
Inactive	Reassure America Life Insurance Company	301902	Agent - Health	9/30/2007	11/23/2011
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	1/17/1998	1/2/2003
Inactive	Reassure America Life Insurance Company	300678	Agent - Life	3/12/2002	1/31/2007
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Health	4/15/1992	7/30/2013
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Life	5/31/2001	7/30/2013
Inactive	The Savings Bank Mutual Life Insurance Company of Massachusetts	690290	Agent - Life	12/28/2009	3/31/2014
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	3/16/2012	3/31/2014
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	3/6/2001	2/24/2003
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	9/19/2002	2/14/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	9/19/2002	2/14/2008
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Health	12/13/1996	9/12/2007
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	5/31/2001	9/12/2007
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	5/1/2008	3/31/2014
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	5/1/2008	3/31/2014
Inactive	USG Annuity & Life Company	300457	Agent - Life	6/4/1998	1/1/2004
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	10/12/1993	12/19/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	5/31/2001	1/3/2012
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	1/1/2004	12/1/2007
Inactive	Washington National Insurance Company	300587	Agent - Health	10/1/2004	3/8/2005
Inactive	Washington National Insurance Company	300587	Agent - Life	10/1/2004	3/8/2005
Inactive	West Coast Life Insurance Company	301607	Agent - Life	6/15/2006	12/15/2008
Inactive		300277	Agent - Health	4/30/1998	1/1/2007
Inactive		300277	Agent - Life	5/31/2001	1/1/2007

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Louisville Inc.	401252	Agent - Health	7/1/1993	12/31/2001
Inactive	Acordia of Louisville Inc.	401252	Agent - Life	7/1/1993	12/31/2001
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	8/24/1999	12/31/2001
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	8/24/1999	12/31/2001
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	Thielmeier, Ernest Charles	353429	Agent - Health	10/9/1979	3/31/2014
Inactive	Thielmeier, Ernest Charles	353429	Agent - Life	10/9/1979	3/31/2014