DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mid South Benefit Plans of Kentucky Inc.	DOIID	401316	NAIC NPN	36621

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Administrator	Not Applicable	4/30/1991	3/31/1999
Inactive	Resident	Agent	General Lines	12/5/1994	7/17/2000
* 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	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - General Lines	12/5/1994	7/17/2000

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Brown, Amberry L	361072	Administrator - Not Applicable	4/30/1991	3/31/1997
Inactive	McCulloch, Mark L	372533	Agent - General Lines	12/5/1994	8/15/2000
Inactive	Scarbrough, Ernest W	335301	Administrator - Not Applicable	4/30/1991	3/31/1997