DEPARTMENT OF INSURANCE
Affiliations
NameCreative Employee Benefits, Inc.DOIID400416NAIC NPN7222394
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAgentHealth4/13/20213/31/2023 
InactiveResidentAgentLife4/13/20213/31/2023 
InactiveResidentAgentHealth Maintenance Organization1/19/19957/14/1997 
InactiveResidentAgentPrepaid Dental Plan9/12/20003/1/2001 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAetna Health Inc.300694Agent - Health5/23/20013/31/2007
InactiveAetna Life Insurance Company301140Agent - Health5/23/20013/31/2007
InactiveAetna Life Insurance Company301140Agent - Life5/23/20013/31/2007
InactiveBoston Mutual Life Insurance Company300143Agent - Health3/16/20233/31/2023
InactiveBoston Mutual Life Insurance Company300143Agent - Life3/16/20233/31/2023
InactiveColonial Life and Accident Insurance Company300846Agent - Health5/24/199311/7/2006
InactiveColonial Life and Accident Insurance Company300846Agent - Life5/24/199311/7/2006
InactiveDentiCare, Inc.300655Agent - Health3/1/200111/1/2005
InactiveDentiCare, Inc.300655Agent - Prepaid Dental Plan9/12/20003/1/2001
InactiveHumana Health Plan, Inc.300142Agent - Health2/14/20023/31/2007
InactiveHumana Health Plan, Inc.300142Agent - Health Maintenance Organization1/19/19957/14/1997
InactiveHumana Insurance Company300118Agent - Health1/19/19957/14/1997
InactiveHumana Insurance Company301104Agent - Health2/14/20023/31/2007
InactiveHumana Insurance Company300118Agent - Life1/19/19957/14/1997
InactiveHumana Insurance Company301104Agent - Life2/14/20023/31/2007
InactiveNorthern Life Insurance Company300301Agent - Health6/5/199110/2/2002
InactiveNorthern Life Insurance Company300301Agent - Life6/5/199110/2/2002
InactiveProtective Life Insurance Company300638Agent - Health9/12/200012/15/2003
InactiveProtective Life Insurance Company300638Agent - Life9/12/200012/15/2003
InactiveReliaStar Life Insurance Company301712Agent - Health7/1/199410/31/2004
InactiveReliaStar Life Insurance Company301712Agent - Life7/1/199410/31/2004
InactiveSecurity-Connecticut Life Insurance Company300316Agent - Life10/8/200210/1/2003
InactiveShenandoah Life Insurance Company300130Agent - Health6/23/19928/12/1996
InactiveShenandoah Life Insurance Company300130Agent - Life6/23/19928/12/1996
InactiveUnion Security Insurance Company301844Agent - Health2/7/20023/31/2007
InactiveUnion Security Insurance Company301844Agent - Life2/7/20023/31/2007
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health4/30/200110/19/2005
InactiveWilco Life Insurance Company300122Agent - Health7/25/19893/31/1997
InactiveWilco Life Insurance Company300122Agent - Life7/25/19893/31/1997
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAllen, Rexford Vandyke 378038Agent - Health11/23/199212/1/2000
InactiveAllen, Rexford Vandyke 378038Agent - Life11/23/199212/1/2000
InactiveBarnum, Timothy Wakefield 341963Agent - Health2/12/20031/26/2005
InactiveBarnum, Timothy Wakefield 341963Agent - Life2/12/20031/26/2005
InactiveBongibault, Brandie Ann 536638Agent - Health2/12/20037/1/2004
InactiveBongibault, Brandie Ann 536638Agent - Life2/12/20037/1/2004
InactiveCarrico, William F. 378507Agent - Health11/5/199312/1/2000
InactiveCarrico, William F. 378507Agent - Life11/5/199312/1/2000
InactiveEarp, William H 331432Agent - Health11/5/19933/31/2007
InactiveEarp, William H 331432Agent - Life11/5/19933/31/2007
InactiveGatewood, Lawrence Elbert 325858Agent - Health2/12/20033/31/2007
InactiveGatewood, Lawrence Elbert 325858Agent - Life2/12/20033/31/2007
InactiveHalvarson, Axel H 341976Agent - Health4/13/20213/31/2023
InactiveHalvarson, Axel H 341976Agent - Life4/13/20213/31/2023
InactiveHarlow, Jerry D 321918Agent - Health2/12/20033/31/2007
InactiveHarlow, Jerry D 321918Agent - Life2/12/20033/31/2007
InactiveHarned, Jeffrey D 322872Agent - Health2/12/20033/31/2007
InactiveHarned, Jeffrey D 322872Agent - Life2/12/20033/31/2007
InactiveHarned, Jimmie D 306652Agent - Health2/12/20033/31/2007
InactiveHarned, Jimmie D 306652Agent - Life2/12/20033/31/2007
InactiveLeet, Kevin Monroe 354264Agent - Health11/23/19922/12/2003
InactiveLeet, Kevin Monroe 354264Agent - Life11/23/19922/12/2003
InactiveMudd, Jerome T 381622Agent - Health6/27/198912/1/2000
InactiveMudd, Jerome T 381622Agent - Life6/27/198912/1/2000
InactiveMudd, Jerome T 381622Agent - Prepaid Dental Plan9/12/200012/1/2000
InactiveMyers, Joshua A 338718Agent - Life11/5/19932/22/1996
InactiveMyers, Patsy M 350654Agent - Health6/27/19898/31/2006
InactiveMyers, Patsy M 350654Agent - Life6/27/19898/31/2006
InactiveMyers, Ralph E 392426Agent - Health 7/1/1998
InactiveMyers, Ralph E 392426Agent - Life6/24/19927/1/1998
InactiveMyers, Ralph Edward 393891Agent - Health5/2/202111/30/2022
InactiveMyers, Ralph Edward 393891Agent - Life5/2/202111/30/2022
InactivePayne, Barbara L 568476Agent - Health1/26/20053/31/2007
InactivePayne, Barbara L 568476Agent - Life1/26/20053/31/2007
InactiveSimon, Gary Louis 345821Agent - Health1/26/200512/31/2006
InactiveSimon, Gary Louis 345821Agent - Life1/26/200512/31/2006
InactiveTaylor, Ronald P 349068Agent - Health8/24/199012/1/2000
InactiveTaylor, Ronald P 349068Agent - Life8/24/199012/1/2000
InactiveWarren, Kathy Lynn 349481Agent - Health8/24/19903/31/2007
InactiveWarren, Kathy Lynn 349481Agent - Life8/24/19903/31/2007

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