DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Coolidge, Walter Nathan	DOIID	527352	NAIC NPN	1013607

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	6/11/2001	6/28/2011
Inactive	Non Resident	Agent	Life	6/11/2001	6/28/2011
* 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	Allianz Life Insurance Company of North America	301791	Agent - Health	8/2/2002	6/28/2011
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	8/2/2002	6/28/2011
Inactive	Canada Life Assurance Company	301192	Agent - Health	5/18/2009	3/31/2010
Inactive	Canada Life Assurance Company	301192	Agent - Life	5/18/2009	3/31/2010
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	2/6/2007	6/28/2011
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	2/6/2007	6/28/2011
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/8/2008	6/28/2011
Inactive	Humana Insurance Company	301104	Agent - Health	12/8/2008	6/28/2011
Inactive	Humana Insurance Company	301104	Agent - Life	12/8/2008	6/28/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/8/2008	6/28/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/8/2008	6/28/2011
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/8/2008	6/28/2011
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/8/2008	6/28/2011
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	10/27/2008	6/28/2011
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Life	10/27/2008	6/28/2011
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	10/27/2008	1/14/2011
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	10/27/2008	1/14/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Stop Loss Insurance Services Inc	705855	Agent - Health	5/15/2009	5/20/2011
Inactive	Stop Loss Insurance Services Inc	705855	Agent - Life	5/15/2009	5/20/2011