DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Custom Health Plans Inc. DBA : Trover Health Plans	DOIID	401295	NAIC NPN	2191805

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Administrator	Not Applicable	3/23/1994	3/31/2001
Inactive	Resident	Agent	Health	1/27/1997	12/30/1998
Inactive	Resident	Agent	Health Maintenance Organization	3/25/1999	11/18/1999
Inactive	Resident	Agent	Life	1/27/1997	12/30/1998
* 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	Anthem Life Insurance Company	301209	Agent - Health	1/27/1997	12/30/1998
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/27/1997	12/30/1998
Inactive	Owensboro Community Health Plan HMO Inc.	300906	Agent - Health Maintenance Organization	3/25/1999	11/18/1999

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Western Kentucky Inc.	401302	Agent - Health	2/6/1997	12/30/1998
Inactive	Acordia of Western Kentucky Inc.	401302	Agent - Life	2/6/1997	12/30/1998
Inactive	Berning, Joan E	361125	Administrator - Not Applicable	3/31/1999	11/30/2003
Inactive	Lee, Richard B	303233	Administrator - Not Applicable	3/31/1995	3/31/1997
Inactive	Miller, Kirk L	332917	Administrator - Not Applicable	3/23/1994	3/31/1997
Inactive	Mitchell, Angela Deneen	342123	Administrator - Not Applicable	3/31/1999	9/30/2006
Inactive	Mitchell, Angela Deneen	342123	Agent - Health Maintenance Organization	3/25/1999	11/18/1999
Inactive	Whitsell, Steven Roger	370860	Administrator - Not Applicable	3/31/1997	4/30/2003
Inactive	Whitsell, Steven Roger	370860	Agent - Health	1/27/1997	11/18/1999