DEPARTMENT OF INSURANCE
Affiliations
NameProvident Insurance Agency Inc
DBA : Provident Insurance Agency of Ohio, Inc.
DOIID502290NAIC NPN2828928
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveNon ResidentAgentHealth12/31/19993/3/2006 
InactiveNon ResidentAgentCasualty12/10/20023/3/2006 
InactiveNon ResidentAgentVariable Life and Variable Annuities6/4/20023/3/2006 
InactiveNon ResidentAgentLife12/31/19993/3/2006 
InactiveNon ResidentAgentProperty12/10/20023/3/2006 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAetna Health Inc.300694Agent - Health5/20/20043/3/2006
InactiveAetna Life Insurance Company301140Agent - Health5/20/20043/3/2006
InactiveAetna Life Insurance Company301140Agent - Life5/20/20043/3/2006
InactiveAmerican Family Home Insurance Company301817Agent - Casualty1/14/20033/3/2006
InactiveAmerican Family Home Insurance Company301817Agent - Property1/14/20033/3/2006
InactiveAmerican Modern Home Insurance Company300791Agent - Casualty1/14/20033/3/2006
InactiveAmerican Modern Home Insurance Company300791Agent - Property1/14/20033/3/2006
InactiveAmerican Modern Life Insurance Company301606Agent - Health12/2/20023/3/2006
InactiveAmerican Modern Life Insurance Company301606Agent - Life12/2/20023/3/2006
InactiveBerkshire Life Insurance Company of America300983Agent - Health11/7/20013/7/2005
InactiveBerkshire Life Insurance Company of America300983Agent - Life11/7/20013/7/2005
InactiveDelaware Life Insurance Company301256Agent - Life12/31/200312/30/2004
InactiveDelaware Life Insurance Company301256Agent - Variable Life and Variable Annuities12/31/200312/30/2004
InactiveEverlake Life Insurance Company300873Agent - Life6/3/20043/3/2006
InactiveEverlake Life Insurance Company300873Agent - Variable Life and Variable Annuities6/3/20043/3/2006
InactiveFirst Colony Life Insurance Company301179Agent - Health4/4/20023/3/2006
InactiveFirst Colony Life Insurance Company301179Agent - Life4/4/20023/3/2006
InactiveFirst Penn-Pacific Life Insurance Company301581Agent - Health4/4/20033/3/2006
InactiveFirst Penn-Pacific Life Insurance Company301581Agent - Life4/4/20033/3/2006
InactiveGenworth Life Insurance Company300623Agent - Health12/31/19994/19/2005
InactiveGenworth Life Insurance Company300623Agent - Life12/31/19994/19/2005
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health8/3/20013/3/2006
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life8/3/20013/3/2006
InactiveGuardian Life Insurance Company of America301316Agent - Health11/7/20013/3/2006
InactiveGuardian Life Insurance Company of America301316Agent - Life11/7/20013/3/2006
InactiveHartford Life and Accident Insurance Company300878Agent - Health1/30/20023/3/2006
InactiveHartford Life and Accident Insurance Company300878Agent - Life1/30/20023/3/2006
InactiveJackson National Life Insurance Company300486Agent - Life5/21/20033/14/2005
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities5/21/20033/14/2005
InactiveJohn Alden Life Insurance Company300573Agent - Health1/23/20031/11/2005
InactiveJohn Alden Life Insurance Company300573Agent - Life1/23/20031/11/2005
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life1/2/20033/3/2006
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Variable Life and Variable Annuities1/2/20033/3/2006
InactiveKeyport Life Insurance Company300319Agent - Life4/24/200312/31/2003
InactiveKeyport Life Insurance Company300319Agent - Variable Life and Variable Annuities4/24/200312/31/2003
InactiveLincoln Benefit Life Company301110Agent - Health1/26/20051/31/2005
InactiveLincoln Benefit Life Company301110Agent - Life1/26/20051/31/2005
InactiveLincoln Benefit Life Company301110Agent - Variable Life and Variable Annuities1/26/20053/3/2006
InactiveLincoln National Life Insurance Company (The)301382Agent - Health3/11/200312/20/2004
InactiveLincoln National Life Insurance Company (The)301382Agent - Life3/11/200312/20/2004
InactiveMassMutual Ascend Life Insurance Company300320Agent - Health12/18/200012/31/2002
InactiveMassMutual Ascend Life Insurance Company300320Agent - Life12/18/200012/31/2002
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Life7/26/20043/3/2006
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Variable Life and Variable Annuities7/26/20043/3/2006
DeniedNassau Life Insurance Company301406Agent - Health  
DeniedNassau Life Insurance Company301406Agent - Life  
InactiveNassau Life and Annuity Company513671Agent - Health11/21/20004/16/2003
InactiveNassau Life and Annuity Company513671Agent - Life11/21/20004/16/2003
InactiveNationwide Life Insurance Company300495Agent - Health8/1/20023/3/2006
InactiveNationwide Life Insurance Company300495Agent - Life8/1/20023/3/2006
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities6/4/20023/3/2006
InactiveNationwide Life and Annuity Insurance Company300714Agent - Life8/1/20023/3/2006
InactiveNationwide Life and Annuity Insurance Company300714Agent - Variable Life and Variable Annuities8/1/20023/3/2006
InactiveNew York Life Insurance and Annuity Corporation300726Agent - Life11/26/20023/3/2006
InactiveNew York Life Insurance and Annuity Corporation300726Agent - Variable Life and Variable Annuities11/26/20023/3/2006
InactivePHL Variable Insurance Company300525Agent - Health12/12/20003/3/2006
InactivePHL Variable Insurance Company300525Agent - Life12/12/20004/27/2005
InactivePaul Revere Life Insurance Company300971Agent - Health4/4/200012/11/2002
InactivePaul Revere Life Insurance Company300971Agent - Life4/4/200012/11/2002
InactivePrincipal Life Insurance Company300129Agent - Health5/4/20043/3/2006
InactivePrincipal Life Insurance Company300129Agent - Life5/4/20043/3/2006
InactiveProvident Life and Accident Insurance Company301525Agent - Health4/4/20003/3/2006
InactiveProvident Life and Accident Insurance Company301525Agent - Life4/4/20003/3/2006
InactivePrudential Insurance Company of America300784Agent - Health9/25/20023/3/2006
InactivePrudential Insurance Company of America300784Agent - Life9/25/20023/3/2006
InactiveReliaStar Life Insurance Company301712Agent - Health8/6/20043/3/2006
InactiveReliaStar Life Insurance Company301712Agent - Life8/6/20043/3/2006
InactiveSouthern Financial Life Insurance Company300664Agent - Health6/20/20033/3/2006
InactiveSouthern Financial Life Insurance Company300664Agent - Life6/20/20033/3/2006
InactiveStandard Insurance Company300185Agent - Health9/4/20013/3/2006
InactiveStandard Insurance Company300185Agent - Life9/4/20013/3/2006
InactiveTalcott Resolution Life Insurance Company301759Agent - Health9/12/20023/3/2006
InactiveTalcott Resolution Life Insurance Company301759Agent - Life9/12/20023/3/2006
InactiveTransamerica Life Insurance Company300571Agent - Life11/15/20027/1/2004
InactiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities11/15/20027/1/2004
InactiveTransamerica Occidental Life Insurance Company300966Agent - Life3/25/200311/2/2004
InactiveTransamerica Occidental Life Insurance Company300966Agent - Variable Life and Variable Annuities3/25/200311/2/2004
InactiveU.S. Financial Life Insurance Company301812Agent - Life10/10/20053/3/2006
InactiveUNUM Life Insurance Company of America300817Agent - Health4/4/20003/3/2006
InactiveUNUM Life Insurance Company of America300817Agent - Life4/4/20003/3/2006
InactiveUSG Annuity & Life Company300457Agent - Life7/14/20031/1/2004
InactiveUnion Central Life Insurance Company300307Agent - Health12/15/20033/3/2006
InactiveUnion Central Life Insurance Company300307Agent - Life12/15/20033/3/2006
InactiveUnion Security Insurance Company301844Agent - Health8/6/20023/3/2006
InactiveUnion Security Insurance Company301844Agent - Life8/6/20023/3/2006
InactiveUnited of Omaha Life Insurance Company300156Agent - Health8/20/20013/3/2006
InactiveUnited of Omaha Life Insurance Company300156Agent - Life8/20/20013/3/2006
InactiveVenerable Insurance and Annuity Company301006Agent - Life1/1/20043/3/2006
InactiveWest Coast Life Insurance Company301607Agent - Life10/24/200212/29/2005
InactiveWestern-Southern Life Assurance Company301590Agent - Health7/31/20023/3/2006
InactiveWestern-Southern Life Assurance Company301590Agent - Life7/31/20023/3/2006
InactiveWestern-Southern Life Assurance Company301590Agent - Variable Life and Variable Annuities7/31/20023/3/2006
Inactive300277Agent - Life2/13/20043/3/2006
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBarger, Douglas A 343478Agent - Health2/24/20033/3/2006
InactiveBarger, Douglas A 343478Agent - Life2/24/20033/3/2006
InactiveBarger, Loyal J 312161Agent - Health2/24/20039/30/2005
InactiveBarger, Loyal J 312161Agent - Life2/24/20039/30/2005
InactiveDoll, Thomas A 332377Agent - Health2/24/20033/3/2006
InactiveDoll, Thomas A 332377Agent - Life2/24/20033/3/2006
InactiveHoehn, David C 309479Agent - Health12/31/19993/3/2006
InactiveHoehn, David C 309479Agent - Life12/31/19993/3/2006
InactiveKollmeier, Dwight L 308190Agent - Casualty12/10/20023/3/2006
InactiveKollmeier, Dwight L 308190Agent - Property12/10/20023/3/2006
InactiveSimmons, Shawn E 307344Agent - Variable Life and Variable Annuities6/4/20023/3/2006
InactiveWenstrup, John A 368003Agent - Health12/31/19992/27/2003
InactiveWenstrup, John A 368003Agent - Life12/31/19992/27/2003

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