PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameSelf, Charles EDOIID526293NAIC NPN3309779
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentCasualty2/11/2016 11/30/2027
ActiveNon ResidentAgentLife2/11/2016 11/30/2027
ActiveNon ResidentAgentProperty2/11/2016 11/30/2027
ActiveNon ResidentAgentHealth2/11/2016 11/30/2027
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAll Savers Insurance Company301940Agent - Health12/19/2023 
ActiveAll Savers Insurance Company301940Agent - Life12/19/2023 
InactiveAmerican Economy Insurance Company300315Agent - Casualty11/9/20195/27/2022
InactiveAmerican Economy Insurance Company300315Agent - Property11/9/20195/27/2022
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Health3/12/20207/24/2020
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Life3/12/20207/24/2020
InactiveAmerican Southern Home Insurance Company626276Agent - Casualty4/9/201811/14/2021
InactiveAmerican Southern Home Insurance Company626276Agent - Property4/9/201811/14/2021
InactiveAnthem Life Insurance Company301209Agent - Health8/24/201011/30/2015
InactiveAnthem Life Insurance Company301209Agent - Life8/24/201011/30/2015
InactiveBristol West Insurance Company301655Agent - Casualty10/31/202112/20/2024
InactiveBristol West Insurance Company301655Agent - Property10/31/202112/20/2024
InactiveColonial Life and Accident Insurance Company300846Agent - Health9/7/20014/12/2006
InactiveColonial Life and Accident Insurance Company300846Agent - Life9/7/20014/12/2006
InactiveCompBenefits Dental, Inc.591692Agent - Health4/14/201112/8/2015
InactiveDental Concern Inc. (The)301641Agent - Health4/14/201112/8/2015
InactiveEncompass Indemnity Company546376Agent - Casualty5/5/202110/3/2024
InactiveEncompass Indemnity Company546376Agent - Property5/5/202110/3/2024
ActiveErie Family Life Insurance Company301400Agent - Health9/15/2023 
ActiveErie Family Life Insurance Company301400Agent - Life9/15/2023 
ActiveErie Insurance Company300230Agent - Casualty9/15/2023 
ActiveErie Insurance Company300230Agent - Property9/15/2023 
ActiveErie Insurance Company of New York789916Agent - Casualty2/23/2018 
ActiveErie Insurance Company of New York789916Agent - Property2/23/2018 
ActiveErie Insurance Exchange300789Agent - Casualty2/23/2018 
ActiveErie Insurance Exchange300789Agent - Property2/23/2018 
InactiveFarmers Property and Casualty Insurance Company301237Agent - Casualty9/12/20184/26/2024
InactiveFarmers Property and Casualty Insurance Company301237Agent - Property9/12/20184/26/2024
ActiveFlagship City Insurance Company789965Agent - Casualty2/23/2018 
ActiveFlagship City Insurance Company789965Agent - Property2/23/2018 
ActiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Casualty2/23/2016 
ActiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Property2/23/2016 
InactiveForemost Property and Casualty Insurance Company300871Agent - Casualty9/21/20175/11/2018
InactiveForemost Property and Casualty Insurance Company300871Agent - Property9/21/20175/11/2018
InactiveForemost Signature Insurance Company300140Agent - Casualty9/21/20175/11/2018
InactiveForemost Signature Insurance Company300140Agent - Property9/21/20175/11/2018
InactiveHumana Health Plan, Inc.300142Agent - Health4/14/201112/8/2015
InactiveHumana Insurance Company301104Agent - Health4/14/201112/8/2015
InactiveHumana Insurance Company301104Agent - Life4/14/201112/8/2015
InactiveHumana Insurance Company of Kentucky300826Agent - Health4/14/201112/8/2015
InactiveHumana Insurance Company of Kentucky300826Agent - Life4/14/201112/8/2015
ActiveIllinois Casualty Company1250052Agent - Casualty9/19/2025 
ActiveIllinois Casualty Company1250052Agent - Property9/19/2025 
InactiveJefferson Pilot Financial Insurance Company300756Agent - Health2/2/20077/2/2007
InactiveJefferson Pilot Financial Insurance Company300756Agent - Life2/2/20077/2/2007
InactiveJohn Alden Life Insurance Company300573Agent - Health10/2/20121/24/2013
InactiveJohn Alden Life Insurance Company300573Agent - Life10/2/20121/24/2013
InactiveKanawha Insurance Company300127Agent - Health4/14/201110/22/2015
InactiveKanawha Insurance Company300127Agent - Life4/14/201110/22/2015
InactiveLincoln National Life Insurance Company (The)301382Agent - Health6/29/200711/30/2007
InactiveLincoln National Life Insurance Company (The)301382Agent - Life6/29/200711/30/2007
InactiveProgressive Casualty Insurance Company300696Agent - Casualty4/29/201411/30/2015
InactiveProgressive Casualty Insurance Company300696Agent - Property4/29/201411/30/2015
ActiveSAFECO Insurance Company of America300159Agent - Casualty4/6/2018 
ActiveSAFECO Insurance Company of America300159Agent - Property4/6/2018 
InactiveSAFECO Insurance Company of Illinois301350Agent - Casualty4/6/20185/27/2022
InactiveSAFECO Insurance Company of Illinois301350Agent - Property4/6/20185/27/2022
ActiveSelective Insurance Company of the Southeast300381Agent - Casualty3/29/2018 
ActiveSelective Insurance Company of the Southeast300381Agent - Property3/29/2018 
InactiveStandard Security Life Insurance Company of NY301487Agent - Health6/12/201411/30/2015
InactiveStandard Security Life Insurance Company of NY301487Agent - Life6/12/201411/30/2015
InactiveState Automobile Mutual Insurance Company301824Agent - Casualty9/28/201812/16/2021
InactiveState Automobile Mutual Insurance Company301824Agent - Property9/28/201812/16/2021
InactiveTime Insurance Company300683Agent - Health9/27/201212/20/2014
InactiveTime Insurance Company300683Agent - Life9/27/201212/20/2014
InactiveUnited Casualty Insurance Company of America301322Agent - Casualty7/9/20011/2/2004
InactiveUnited Casualty Insurance Company of America301322Agent - Property7/9/20011/2/2004
InactiveUnited Insurance Company of America300775Agent - Health7/9/20011/2/2004
InactiveUnited Insurance Company of America300775Agent - Life7/9/20011/2/2004
InactiveUnitedHealthcare Insurance Company300946Agent - Health3/22/202212/17/2024
InactiveUnitedHealthcare Insurance Company300946Agent - Life3/22/202212/17/2024
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health3/22/202212/17/2024
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Life1/1/20211/7/2021
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health3/22/202212/17/2024
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Life1/1/20211/7/2021
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveDesignated Agent Company Inc.681257Agent - Life8/24/201011/30/2015
InactiveDesignated Agent Company Inc.681257Agent - Health8/24/201011/30/2015
ActiveSelf Insurance Services, LLC792398Agent - Life10/9/2020 
ActiveSelf Insurance Services, LLC792398Agent - Health10/9/2020 
ActiveSelf Insurance Services, LLC792398Agent - Property3/3/2016 
ActiveSelf Insurance Services, LLC792398Agent - Casualty3/3/2016 

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