DEPARTMENT OF INSURANCE

Affiliations

Name	Bluegrass Insurance Services Inc.	DOIID	401050	NAIC NPN	7222874

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health Maintenance Organization	7/27/1995	11/1/2000
Inactive	Resident	Agent	Life	11/25/1991	5/31/2003
Inactive	Resident	Agent	Health	11/25/1991	5/31/2003
Inactive	Resident	Agent	Prepaid Dental Plan	4/27/1994	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 Life Insurance Company	301140	Agent - Health	9/26/1995	5/31/2003
Inactive	Aetna Life Insurance Company	301140	Agent - Life	9/26/1995	5/31/2003
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	3/7/1996	5/31/2003
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	3/7/1996	5/31/2003
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	12/11/1998	12/11/2000
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	12/11/1998	12/11/2000
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/7/1999	5/31/2003
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/7/1999	5/31/2003
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Health	2/18/1997	5/31/2003
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	2/18/1997	5/31/2003
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	6/27/2001	5/31/2003
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	6/27/2001	5/31/2003
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	11/18/1992	5/31/2003
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	11/18/1992	5/31/2003
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	4/24/1996	5/31/2003
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	4/24/1996	5/31/2003
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	6/28/1994	6/6/2001
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	6/28/1994	6/6/2001
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Health	8/28/1995	12/30/1998
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	8/28/1995	12/30/1998
Inactive	First Allmerica Financial Life Insurance Company	301853	Agent - Health	2/2/1994	3/31/1997
Inactive	First Allmerica Financial Life Insurance Company	301853	Agent - Life	2/2/1994	3/31/1997
Inactive	First Colony Life Insurance Company	301179	Agent - Life	2/7/1992	5/31/2003
Inactive	General American Life Insurance Company	300280	Agent - Health	11/25/1991	8/14/2000
Inactive	General American Life Insurance Company	300280	Agent - Life	11/25/1991	8/14/2000
Inactive	Guarantee Life Insurance Company	301560	Agent - Health	6/6/1996	9/8/2000
Inactive	Guarantee Life Insurance Company	301560	Agent - Life	6/6/1996	9/8/2000
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	7/1/1997	5/31/2003
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	7/1/1997	5/31/2003
Inactive	Health Resources Inc.	301210	Agent - Health	3/1/2001	12/30/2002
Inactive	Health Resources Inc.	301210	Agent - Prepaid Dental Plan	4/27/1994	3/1/2001
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	7/27/1995	11/1/2000
Inactive	Humana Insurance Company	300118	Agent - Health	7/27/1995	12/30/1998
Inactive	Humana Insurance Company	300118	Agent - Life	7/27/1995	12/30/1998
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	9/8/2000	5/31/2003
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	9/8/2000	5/31/2003
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	7/3/1995	5/31/2003
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	7/3/1995	5/31/2003
Inactive	Principal Life Insurance Company	300129	Agent - Health	11/18/1999	5/31/2003
Inactive	Principal Life Insurance Company	300129	Agent - Life	11/18/1999	5/31/2003
Inactive	Reassure America Life Insurance Company	301902	Agent - Health	3/14/1997	1/2/2003
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	3/14/1997	1/2/2003
Inactive	SeeChange Health Insurance Company	301115	Agent - Health	5/27/1994	3/31/1997
Inactive	SeeChange Health Insurance Company	301115	Agent - Life	5/27/1994	3/31/1997
Inactive	Time Insurance Company	300683	Agent - Health	11/20/1999	2/20/2001
Inactive	Time Insurance Company	300683	Agent - Life	11/20/1999	2/20/2001
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	5/15/1998	5/31/2003
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	5/15/1998	5/31/2003
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/24/1995	5/31/2003
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	7/24/1995	5/31/2003

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Blaine, Kevin Wood	345907	Agent - Health	11/25/1991	5/31/2003
Inactive	Blaine, Kevin Wood	345907	Agent - Life	11/25/1991	5/31/2003
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	West Kentucky Group Benefits	401049	Agent - Health	12/9/1991	12/31/2001
Inactive	West Kentucky Group Benefits	401049	Agent - Life	12/9/1991	12/31/2001