DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	KMH Financial Benefits	DOIID	400544	NAIC NPN	7222487

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	4/16/1997	4/22/2002
Inactive	Resident	Agent	Health Maintenance Organization	9/15/1997	3/1/2001
Inactive	Resident	Agent	Life	4/16/1997	4/22/2002
* 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 Heritage Life Insurance Company	300272	Agent - Health	4/16/1997	4/22/2002
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	4/16/1997	4/22/2002
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/26/1997	12/31/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/26/1997	12/31/1998
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	4/22/2002
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	9/15/1997	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	8/12/1997	4/22/2002
Inactive	Humana Insurance Company	301104	Agent - Life	8/12/1997	4/22/2002

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Holthouser, Kenneth Muir	315516	Agent - Health	5/6/1997	9/13/2000
Inactive	Holthouser, Kenneth Muir	315516	Agent - Life	5/6/1997	9/13/2000