DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Kirk Wyatt	DOIID	510901	NAIC NPN	1283306

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	6/26/2000		10/31/2025
Active	Non Resident	Agent	Life	6/26/2000		10/31/2025
Inactive	Non Resident	Agent	Health Maintenance Organization	6/26/2000	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 Health Inc. (PA)	660717	Agent - Health	4/23/2008	7/5/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	4/23/2008	7/5/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Life	4/23/2008	7/5/2022
Active	Anthem Life Insurance Company	301209	Agent - Health	1/4/2017
Active	Anthem Life Insurance Company	301209	Agent - Life	1/4/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	7/6/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	6/26/2000	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	6/26/2000	7/6/2012
Inactive	Humana Insurance Company	301104	Agent - Life	6/26/2000	7/6/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	7/6/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	7/6/2012
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	4/9/2001
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	4/9/2001
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	11/6/2000	12/7/2011
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	11/6/2000	12/7/2011
Active	Trustmark Insurance Company	300317	Agent - Health	9/12/2000
Active	Trustmark Insurance Company	300317	Agent - Life	9/12/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dental Choice Agency Inc.	398085	Agent - Health	3/21/2016
Active	Designated Agent Company Inc.	681257	Agent - Life	1/4/2017
Active	Designated Agent Company Inc.	681257	Agent - Health	1/4/2017
Inactive	MHBT Inc	751485	Agent - Life	4/6/2011	6/14/2016
Inactive	MHBT Inc	751485	Agent - Health	4/6/2011	6/14/2016
Active	Marsh & Mclennan Agency LLC	716460	Agent - Life	7/29/2015
Active	Marsh & Mclennan Agency LLC	716460	Agent - Health	7/29/2015
Inactive	Mc & H Life Agency Inc	666620	Agent - Life	10/31/2007	6/16/2016
Inactive	Mc & H Life Agency Inc	666620	Agent - Health	10/31/2007	6/16/2016