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DEPARTMENT OF INSURANCE
Affiliations
Name
Provident Insurance Agency Inc
DBA : Provident Insurance Agency of Ohio, Inc.
DOIID
502290
NAIC NPN
2828928
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Non Resident
Agent
Health
12/31/1999
3/3/2006
Inactive
Non Resident
Agent
Casualty
12/10/2002
3/3/2006
Inactive
Non Resident
Agent
Variable Life and Variable Annuities
6/4/2002
3/3/2006
Inactive
Non Resident
Agent
Life
12/31/1999
3/3/2006
Inactive
Non Resident
Agent
Property
12/10/2002
3/3/2006
* If a status Is
Pending, Pending Replacement
,Or the record displays
Affidavit On File
, click On them For more details.
Notice:
The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Aetna Health Inc.
300694
Agent - Health
5/20/2004
3/3/2006
Inactive
Aetna Life Insurance Company
301140
Agent - Health
5/20/2004
3/3/2006
Inactive
Aetna Life Insurance Company
301140
Agent - Life
5/20/2004
3/3/2006
Inactive
American Family Home Insurance Company
301817
Agent - Casualty
1/14/2003
3/3/2006
Inactive
American Family Home Insurance Company
301817
Agent - Property
1/14/2003
3/3/2006
Inactive
American Modern Home Insurance Company
300791
Agent - Casualty
1/14/2003
3/3/2006
Inactive
American Modern Home Insurance Company
300791
Agent - Property
1/14/2003
3/3/2006
Inactive
American Modern Life Insurance Company
301606
Agent - Health
12/2/2002
3/3/2006
Inactive
American Modern Life Insurance Company
301606
Agent - Life
12/2/2002
3/3/2006
Inactive
Berkshire Life Insurance Company of America
300983
Agent - Health
11/7/2001
3/7/2005
Inactive
Berkshire Life Insurance Company of America
300983
Agent - Life
11/7/2001
3/7/2005
Inactive
Delaware Life Insurance Company
301256
Agent - Life
12/31/2003
12/30/2004
Inactive
Delaware Life Insurance Company
301256
Agent - Variable Life and Variable Annuities
12/31/2003
12/30/2004
Inactive
Everlake Life Insurance Company
300873
Agent - Life
6/3/2004
3/3/2006
Inactive
Everlake Life Insurance Company
300873
Agent - Variable Life and Variable Annuities
6/3/2004
3/3/2006
Inactive
First Colony Life Insurance Company
301179
Agent - Health
4/4/2002
3/3/2006
Inactive
First Colony Life Insurance Company
301179
Agent - Life
4/4/2002
3/3/2006
Inactive
First Penn-Pacific Life Insurance Company
301581
Agent - Health
4/4/2003
3/3/2006
Inactive
First Penn-Pacific Life Insurance Company
301581
Agent - Life
4/4/2003
3/3/2006
Inactive
Genworth Life Insurance Company
300623
Agent - Health
12/31/1999
4/19/2005
Inactive
Genworth Life Insurance Company
300623
Agent - Life
12/31/1999
4/19/2005
Inactive
Genworth Life and Annuity Insurance Company
301276
Agent - Health
8/3/2001
3/3/2006
Inactive
Genworth Life and Annuity Insurance Company
301276
Agent - Life
8/3/2001
3/3/2006
Inactive
Guardian Life Insurance Company of America
301316
Agent - Health
11/7/2001
3/3/2006
Inactive
Guardian Life Insurance Company of America
301316
Agent - Life
11/7/2001
3/3/2006
Inactive
Hartford Life and Accident Insurance Company
300878
Agent - Health
1/30/2002
3/3/2006
Inactive
Hartford Life and Accident Insurance Company
300878
Agent - Life
1/30/2002
3/3/2006
Inactive
Jackson National Life Insurance Company
300486
Agent - Life
5/21/2003
3/14/2005
Inactive
Jackson National Life Insurance Company
300486
Agent - Variable Life and Variable Annuities
5/21/2003
3/14/2005
Inactive
John Alden Life Insurance Company
300573
Agent - Health
1/23/2003
1/11/2005
Inactive
John Alden Life Insurance Company
300573
Agent - Life
1/23/2003
1/11/2005
Inactive
John Hancock Life Insurance Company (U.S.A.)
300132
Agent - Life
1/2/2003
3/3/2006
Inactive
John Hancock Life Insurance Company (U.S.A.)
300132
Agent - Variable Life and Variable Annuities
1/2/2003
3/3/2006
Inactive
Keyport Life Insurance Company
300319
Agent - Life
4/24/2003
12/31/2003
Inactive
Keyport Life Insurance Company
300319
Agent - Variable Life and Variable Annuities
4/24/2003
12/31/2003
Inactive
Lincoln Benefit Life Company
301110
Agent - Health
1/26/2005
1/31/2005
Inactive
Lincoln Benefit Life Company
301110
Agent - Life
1/26/2005
1/31/2005
Inactive
Lincoln Benefit Life Company
301110
Agent - Variable Life and Variable Annuities
1/26/2005
3/3/2006
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Health
3/11/2003
12/20/2004
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Life
3/11/2003
12/20/2004
Inactive
MassMutual Ascend Life Insurance Company
300320
Agent - Health
12/18/2000
12/31/2002
Inactive
MassMutual Ascend Life Insurance Company
300320
Agent - Life
12/18/2000
12/31/2002
Inactive
MetLife Life and Annuity Company of Connecticut
301593
Agent - Life
7/26/2004
3/3/2006
Inactive
MetLife Life and Annuity Company of Connecticut
301593
Agent - Variable Life and Variable Annuities
7/26/2004
3/3/2006
Denied
Nassau Life Insurance Company
301406
Agent - Health
Denied
Nassau Life Insurance Company
301406
Agent - Life
Inactive
Nassau Life and Annuity Company
513671
Agent - Health
11/21/2000
4/16/2003
Inactive
Nassau Life and Annuity Company
513671
Agent - Life
11/21/2000
4/16/2003
Inactive
Nationwide Life Insurance Company
300495
Agent - Health
8/1/2002
3/3/2006
Inactive
Nationwide Life Insurance Company
300495
Agent - Life
8/1/2002
3/3/2006
Inactive
Nationwide Life Insurance Company
300495
Agent - Variable Life and Variable Annuities
6/4/2002
3/3/2006
Inactive
Nationwide Life and Annuity Insurance Company
300714
Agent - Life
8/1/2002
3/3/2006
Inactive
Nationwide Life and Annuity Insurance Company
300714
Agent - Variable Life and Variable Annuities
8/1/2002
3/3/2006
Inactive
New York Life Insurance and Annuity Corporation
300726
Agent - Life
11/26/2002
3/3/2006
Inactive
New York Life Insurance and Annuity Corporation
300726
Agent - Variable Life and Variable Annuities
11/26/2002
3/3/2006
Inactive
PHL Variable Insurance Company
300525
Agent - Health
12/12/2000
3/3/2006
Inactive
PHL Variable Insurance Company
300525
Agent - Life
12/12/2000
4/27/2005
Inactive
Paul Revere Life Insurance Company
300971
Agent - Health
4/4/2000
12/11/2002
Inactive
Paul Revere Life Insurance Company
300971
Agent - Life
4/4/2000
12/11/2002
Inactive
Principal Life Insurance Company
300129
Agent - Health
5/4/2004
3/3/2006
Inactive
Principal Life Insurance Company
300129
Agent - Life
5/4/2004
3/3/2006
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Health
4/4/2000
3/3/2006
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Life
4/4/2000
3/3/2006
Inactive
Prudential Insurance Company of America
300784
Agent - Health
9/25/2002
3/3/2006
Inactive
Prudential Insurance Company of America
300784
Agent - Life
9/25/2002
3/3/2006
Inactive
ReliaStar Life Insurance Company
301712
Agent - Health
8/6/2004
3/3/2006
Inactive
ReliaStar Life Insurance Company
301712
Agent - Life
8/6/2004
3/3/2006
Inactive
Southern Financial Life Insurance Company
300664
Agent - Health
6/20/2003
3/3/2006
Inactive
Southern Financial Life Insurance Company
300664
Agent - Life
6/20/2003
3/3/2006
Inactive
Standard Insurance Company
300185
Agent - Health
9/4/2001
3/3/2006
Inactive
Standard Insurance Company
300185
Agent - Life
9/4/2001
3/3/2006
Inactive
Talcott Resolution Life Insurance Company
301759
Agent - Health
9/12/2002
3/3/2006
Inactive
Talcott Resolution Life Insurance Company
301759
Agent - Life
9/12/2002
3/3/2006
Inactive
Transamerica Life Insurance Company
300571
Agent - Life
11/15/2002
7/1/2004
Inactive
Transamerica Life Insurance Company
300571
Agent - Variable Life and Variable Annuities
11/15/2002
7/1/2004
Inactive
Transamerica Occidental Life Insurance Company
300966
Agent - Life
3/25/2003
11/2/2004
Inactive
Transamerica Occidental Life Insurance Company
300966
Agent - Variable Life and Variable Annuities
3/25/2003
11/2/2004
Inactive
U.S. Financial Life Insurance Company
301812
Agent - Life
10/10/2005
3/3/2006
Inactive
UNUM Life Insurance Company of America
300817
Agent - Health
4/4/2000
3/3/2006
Inactive
UNUM Life Insurance Company of America
300817
Agent - Life
4/4/2000
3/3/2006
Inactive
USG Annuity & Life Company
300457
Agent - Life
7/14/2003
1/1/2004
Inactive
Union Central Life Insurance Company
300307
Agent - Health
12/15/2003
3/3/2006
Inactive
Union Central Life Insurance Company
300307
Agent - Life
12/15/2003
3/3/2006
Inactive
Union Security Insurance Company
301844
Agent - Health
8/6/2002
3/3/2006
Inactive
Union Security Insurance Company
301844
Agent - Life
8/6/2002
3/3/2006
Inactive
United of Omaha Life Insurance Company
300156
Agent - Health
8/20/2001
3/3/2006
Inactive
United of Omaha Life Insurance Company
300156
Agent - Life
8/20/2001
3/3/2006
Inactive
Venerable Insurance and Annuity Company
301006
Agent - Life
1/1/2004
3/3/2006
Inactive
West Coast Life Insurance Company
301607
Agent - Life
10/24/2002
12/29/2005
Inactive
Western-Southern Life Assurance Company
301590
Agent - Health
7/31/2002
3/3/2006
Inactive
Western-Southern Life Assurance Company
301590
Agent - Life
7/31/2002
3/3/2006
Inactive
Western-Southern Life Assurance Company
301590
Agent - Variable Life and Variable Annuities
7/31/2002
3/3/2006
Inactive
300277
Agent - Life
2/13/2004
3/3/2006
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Barger, Douglas A
343478
Agent - Health
2/24/2003
3/3/2006
Inactive
Barger, Douglas A
343478
Agent - Life
2/24/2003
3/3/2006
Inactive
Barger, Loyal J
312161
Agent - Health
2/24/2003
9/30/2005
Inactive
Barger, Loyal J
312161
Agent - Life
2/24/2003
9/30/2005
Inactive
Doll, Thomas A
332377
Agent - Health
2/24/2003
3/3/2006
Inactive
Doll, Thomas A
332377
Agent - Life
2/24/2003
3/3/2006
Inactive
Hoehn, David C
309479
Agent - Health
12/31/1999
3/3/2006
Inactive
Hoehn, David C
309479
Agent - Life
12/31/1999
3/3/2006
Inactive
Kollmeier, Dwight L
308190
Agent - Casualty
12/10/2002
3/3/2006
Inactive
Kollmeier, Dwight L
308190
Agent - Property
12/10/2002
3/3/2006
Inactive
Simmons, Shawn E
307344
Agent - Variable Life and Variable Annuities
6/4/2002
3/3/2006
Inactive
Wenstrup, John A
368003
Agent - Health
12/31/1999
2/27/2003
Inactive
Wenstrup, John A
368003
Agent - Life
12/31/1999
2/27/2003
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