DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Quantum Ins Partners Inc	DOIID	524499	NAIC NPN	3007783

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	6/12/2009	3/31/2013
Inactive	Non Resident	Agent	Life	6/12/2009	3/31/2013
* 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	Banner Life Insurance Company	301696	Agent - Life	2/5/2010	3/31/2013
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	6/23/2009	5/13/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Health	6/23/2009	5/13/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	6/23/2009	5/13/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/23/2009	5/13/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	6/23/2009	5/13/2013
Inactive	Humana Insurance Company	301104	Agent - Health	6/23/2009	5/13/2013
Inactive	Humana Insurance Company	301104	Agent - Life	6/23/2009	5/13/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	6/23/2009	5/13/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	6/23/2009	5/13/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Health	9/1/2011	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	9/1/2011	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	6/23/2009	5/13/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	6/23/2009	5/13/2013
Denied	Time Insurance Company	300683	Agent - Health
Denied	Time Insurance Company	300683	Agent - Life
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	11/5/2010	9/7/2011
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	11/5/2010	9/7/2011

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Flack, Robert Roeland	305967	Agent - Health	6/12/2009	3/31/2013
Inactive	Flack, Robert Roeland	305967	Agent - Life	6/12/2009	3/31/2013