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DEPARTMENT OF INSURANCE
Affiliations
Name
Broad Street Brokerage Insurance Agency, LLC
DOIID
540067
NAIC NPN
5698361
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Non Resident
Agent
Life
1/3/2002
11/8/2024
Inactive
Non Resident
Agent
Health
1/3/2002
11/8/2024
* 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
AF&L Insurance Company
301582
Agent - Health
4/29/2002
5/20/2003
Inactive
Aetna Health Inc.
300694
Agent - Health
9/1/2006
12/31/2007
Inactive
Aetna Health Inc. (PA)
660717
Agent - Health
12/31/2007
6/30/2022
Inactive
Aetna Life Insurance Company
301140
Agent - Health
9/1/2006
6/30/2022
Inactive
Aetna Life Insurance Company
301140
Agent - Life
9/1/2006
6/30/2022
Inactive
American General Life Insurance Company
301585
Agent - Health
8/22/2008
11/9/2012
Inactive
American General Life Insurance Company
301585
Agent - Life
8/22/2008
11/9/2012
Inactive
American Heritage Life Insurance Company
300272
Agent - Health
5/3/2011
6/28/2013
Inactive
American Heritage Life Insurance Company
300272
Agent - Life
5/3/2011
6/28/2013
Inactive
American National Insurance Company
301861
Agent - Health
1/19/2012
5/26/2021
Inactive
American National Insurance Company
301861
Agent - Life
1/19/2012
4/26/2024
Inactive
Annuity Investors Life Insurance Company
300715
Agent - Health
2/1/2010
9/29/2011
Inactive
Annuity Investors Life Insurance Company
300715
Agent - Life
2/1/2010
9/29/2011
Inactive
Anthem Health Plans of Kentucky, Inc.
300999
Agent - Health
5/22/2002
11/21/2024
Inactive
Anthem Insurance Companies, Inc.
300941
Agent - Health
5/22/2002
10/16/2012
Inactive
Anthem Life Insurance Company
301209
Agent - Health
5/22/2002
11/21/2024
Inactive
Anthem Life Insurance Company
301209
Agent - Life
5/22/2002
11/21/2024
Inactive
Athene Annuity & Life Assurance Company of New York
300724
Agent - Life
8/4/2004
5/8/2013
Inactive
Banner Life Insurance Company
301696
Agent - Life
7/30/2007
11/8/2024
Inactive
Berkshire Life Insurance Company of America
300983
Agent - Health
9/18/2014
9/24/2018
Inactive
Berkshire Life Insurance Company of America
300983
Agent - Life
9/18/2014
9/24/2018
Inactive
Columbian Life Insurance Company
300810
Agent - Life
9/26/2016
7/9/2024
Inactive
CompBenefits Dental, Inc.
591692
Agent - Health
2/24/2009
12/5/2014
Inactive
CompBenefits Insurance Company
301864
Agent - Health
2/24/2009
7/2/2013
Inactive
CompBenefits Insurance Company
301864
Agent - Life
2/24/2009
7/2/2013
Inactive
Connecticut General Life Insurance Company
301333
Agent - Health
12/15/2009
6/11/2014
Inactive
Connecticut General Life Insurance Company
301333
Agent - Life
12/15/2009
6/11/2014
Inactive
Dental Concern Inc. (The)
301641
Agent - Health
6/21/2010
5/2/2016
Inactive
Empower Annuity Insurance Company of America
300259
Agent - Health
12/15/2009
1/3/2012
Inactive
Empower Annuity Insurance Company of America
300259
Agent - Life
12/15/2009
1/3/2012
Inactive
Encova Life Insurance Company
301818
Agent - Health
1/3/2002
1/1/2024
Inactive
Encova Life Insurance Company
301818
Agent - Life
1/3/2002
1/1/2024
Inactive
Fidelity & Guaranty Life Insurance Company
301359
Agent - Health
11/20/2003
3/14/2012
Inactive
Fidelity & Guaranty Life Insurance Company
301359
Agent - Life
11/20/2003
3/14/2012
Inactive
Genworth Life Insurance Company
300623
Agent - Health
2/7/2008
12/3/2019
Inactive
Genworth Life Insurance Company
300623
Agent - Life
2/7/2008
12/3/2019
Inactive
Genworth Life and Annuity Insurance Company
301276
Agent - Health
8/22/2007
12/22/2016
Inactive
Genworth Life and Annuity Insurance Company
301276
Agent - Life
8/22/2007
12/22/2016
Inactive
Guardian Insurance & Annuity Company Inc. (The)
301920
Agent - Life
12/27/2005
10/5/2021
Inactive
Guardian Life Insurance Company of America
301316
Agent - Health
2/28/2005
10/5/2021
Inactive
Guardian Life Insurance Company of America
301316
Agent - Life
2/28/2005
10/5/2021
Inactive
Hartford Life and Accident Insurance Company
300878
Agent - Health
5/5/2010
11/8/2024
Inactive
Hartford Life and Accident Insurance Company
300878
Agent - Life
5/5/2010
11/8/2024
Inactive
Humana Health Plan, Inc.
300142
Agent - Health
12/11/2008
12/5/2014
Inactive
Humana Insurance Company
301104
Agent - Health
12/11/2008
12/8/2015
Inactive
Humana Insurance Company
301104
Agent - Life
12/11/2008
12/8/2015
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Health
7/8/2011
5/2/2016
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Life
7/8/2011
5/2/2016
Inactive
HumanaDental Insurance Company
301457
Agent - Health
7/8/2011
5/13/2013
Inactive
HumanaDental Insurance Company
301457
Agent - Life
7/8/2011
5/13/2013
Inactive
Illinois Mutual Life Insurance Company
301479
Agent - Health
3/10/2008
2/29/2016
Inactive
Illinois Mutual Life Insurance Company
301479
Agent - Life
3/10/2008
2/29/2016
Inactive
Jefferson Pilot Financial Insurance Company
300756
Agent - Health
12/5/2006
7/2/2007
Inactive
Jefferson Pilot Financial Insurance Company
300756
Agent - Life
12/5/2006
7/2/2007
Inactive
John Hancock Life Insurance Company
300821
Agent - Health
4/1/2005
12/30/2009
Inactive
John Hancock Life Insurance Company
300821
Agent - Life
4/1/2005
12/30/2009
Inactive
John Hancock Life Insurance Company (U.S.A.)
300132
Agent - Health
9/19/2008
11/8/2024
Inactive
John Hancock Life Insurance Company (U.S.A.)
300132
Agent - Life
9/19/2008
11/8/2024
Inactive
Kanawha Insurance Company
300127
Agent - Health
12/11/2008
12/5/2014
Inactive
Kanawha Insurance Company
300127
Agent - Life
12/11/2008
12/5/2014
Inactive
Lafayette Life Insurance Company (The)
301039
Agent - Health
9/2/2003
1/5/2007
Inactive
Lafayette Life Insurance Company (The)
301039
Agent - Life
9/2/2003
1/5/2007
Inactive
Life Insurance Company of North America
300711
Agent - Health
12/15/2009
11/8/2024
Inactive
Life Insurance Company of North America
300711
Agent - Life
12/15/2009
11/8/2024
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Health
6/29/2007
6/24/2024
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Life
6/29/2007
6/24/2024
Inactive
Loyal American Life Insurance Company
301172
Agent - Health
2/1/2010
6/28/2010
Inactive
Loyal American Life Insurance Company
301172
Agent - Life
2/1/2010
6/28/2010
Inactive
MassMutual Ascend Life Insurance Company
300320
Agent - Health
2/1/2010
12/5/2011
Inactive
MassMutual Ascend Life Insurance Company
300320
Agent - Life
2/1/2010
12/5/2011
Inactive
MetLife Investors USA Insurance Company
300845
Agent - Health
2/13/2009
11/20/2009
Inactive
MetLife Investors USA Insurance Company
300845
Agent - Life
2/13/2009
11/20/2009
Inactive
Mutual of Omaha Insurance Company
301012
Agent - Health
6/10/2002
9/23/2003
Inactive
National Western Life Insurance Company
301515
Agent - Life
1/13/2013
3/28/2014
Inactive
Pan-American Life Insurance Company
301530
Agent - Health
1/1/2024
11/8/2024
Inactive
Pan-American Life Insurance Company
301530
Agent - Life
1/1/2024
11/8/2024
Inactive
Paul Revere Life Insurance Company
300971
Agent - Health
10/4/2016
11/8/2024
Inactive
Paul Revere Life Insurance Company
300971
Agent - Life
10/4/2016
11/8/2024
Inactive
Physicians Life Insurance Company
300924
Agent - Health
3/1/2005
12/14/2006
Inactive
Physicians Life Insurance Company
300924
Agent - Life
3/1/2005
12/14/2006
Inactive
Physicians Mutual Insurance Company
301084
Agent - Health
3/1/2005
12/15/2006
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Health
10/4/2016
11/30/2023
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Life
10/4/2016
11/30/2023
Inactive
Pruco Life Insurance Company
300954
Agent - Health
1/26/2004
12/17/2004
Inactive
Pruco Life Insurance Company
300954
Agent - Life
1/26/2004
12/17/2004
Inactive
Reassure America Life Insurance Company
301902
Agent - Health
5/23/2002
9/3/2004
Inactive
Reassure America Life Insurance Company
301902
Agent - Life
5/23/2002
9/3/2004
Inactive
ReliaStar Life Insurance Company
301712
Agent - Health
9/3/2009
10/5/2012
Inactive
ReliaStar Life Insurance Company
301712
Agent - Life
9/3/2009
10/5/2012
Inactive
Security-Connecticut Life Insurance Company
300316
Agent - Health
7/2/2003
10/1/2003
Inactive
Security-Connecticut Life Insurance Company
300316
Agent - Life
7/2/2003
10/1/2003
Inactive
Standard Insurance Company
300185
Agent - Health
4/15/2005
11/8/2024
Inactive
Standard Insurance Company
300185
Agent - Life
4/15/2005
11/8/2024
Inactive
Starmount Life Insurance Company
628031
Agent - Health
8/27/2020
11/30/2023
Inactive
Sun Life Assurance Company of Canada
301811
Agent - Health
3/10/2008
11/3/2009
Inactive
Sun Life Assurance Company of Canada
301811
Agent - Life
3/10/2008
11/3/2009
Inactive
U.S. Financial Life Insurance Company
301812
Agent - Life
9/6/2006
9/17/2007
Inactive
UNUM Life Insurance Company of America
300817
Agent - Health
10/4/2016
11/30/2023
Inactive
UNUM Life Insurance Company of America
300817
Agent - Life
10/4/2016
11/30/2023
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Health
1/23/2012
4/8/2014
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Life
7/6/2005
4/28/2014
Inactive
UnitedHealthcare of Kentucky, Ltd.
301337
Agent - Health
7/6/2005
4/28/2014
Inactive
UnitedHealthcare of Ohio, Inc.
300493
Agent - Health
1/23/2012
4/8/2014
Inactive
Unum Insurance Company
301499
Agent - Health
8/27/2020
11/30/2023
Inactive
Unum Insurance Company
301499
Agent - Life
8/27/2020
11/30/2023
Inactive
Wellpoint Life and Health Insurance Company
300469
Agent - Health
7/31/2006
12/3/2010
Inactive
Wellpoint Life and Health Insurance Company
300469
Agent - Life
7/31/2006
12/3/2010
Inactive
Western National Life Insurance Company
300461
Agent - Life
6/26/2003
5/19/2007
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Bellamy, Roger Dale
330329
Agent - Health
9/21/2005
11/1/2009
Inactive
Bellamy, Roger Dale
330329
Agent - Life
9/21/2005
11/1/2009
Inactive
Bishop, John J
539860
Agent - Health
1/3/2002
10/31/2006
Inactive
Bishop, John J
539860
Agent - Life
1/3/2002
10/31/2006
Inactive
Boden, Brent
676495
Agent - Health
3/25/2010
3/1/2024
Inactive
Boden, Brent
676495
Agent - Life
3/25/2010
3/1/2024
Inactive
Bradley, Gena M
335642
Agent - Health
4/28/2006
11/8/2024
Inactive
Bradley, Gena M
335642
Agent - Life
1/19/2005
11/8/2024
Denied
Butt, Larry James
320248
Agent - Health
Inactive
Butt, Larry James
320248
Agent - Life
7/26/2011
12/1/2012
Inactive
Chelf, Floyd Nelson
360429
Agent - Health
4/21/2008
8/1/2015
Inactive
Chelf, Floyd Nelson
360429
Agent - Life
4/21/2008
8/1/2015
Inactive
Clements, Gerald W
308331
Agent - Health
4/11/2012
3/31/2021
Inactive
Clements, Gerald W
308331
Agent - Life
4/11/2012
12/28/2020
Denied
Coleman, Kristen Elizabeth
571296
Agent - Health
Inactive
Coleman, Kristen Elizabeth
571296
Agent - Life
4/28/2006
9/1/2016
Inactive
Comerford, Jill
826773
Agent - Health
12/6/2013
7/31/2017
Inactive
Comerford, Jill
826773
Agent - Life
12/6/2013
7/31/2017
Inactive
Danner, Virginia J
551883
Agent - Health
10/21/2009
11/8/2024
Inactive
Danner, Virginia J
551883
Agent - Life
10/21/2009
11/8/2024
Inactive
Davis, William Curtis
364748
Agent - Health
7/25/2011
11/8/2024
Inactive
Davis, William Curtis
364748
Agent - Life
7/25/2011
11/8/2024
Inactive
Dewitt, Benjamin Morris
588388
Agent - Health
1/19/2005
11/8/2024
Inactive
Dewitt, Benjamin Morris
588388
Agent - Life
1/19/2005
11/8/2024
Inactive
Dills, Charles Edward
361995
Agent - Health
6/14/2007
7/2/2014
Inactive
Dills, Charles Edward
361995
Agent - Life
6/14/2007
7/2/2014
Inactive
Dills, Karen Kay
361249
Agent - Health
7/25/2007
11/8/2024
Inactive
Dills, Karen Kay
361249
Agent - Life
7/25/2007
11/8/2024
Inactive
Dodson, Douglas L
540079
Agent - Health
1/3/2002
11/30/2007
Inactive
Dodson, Douglas L
540079
Agent - Life
1/3/2002
11/30/2007
Inactive
Elder, Jason L
307099
Agent - Health
1/19/2005
4/1/2017
Inactive
Elder, Jason L
307099
Agent - Life
1/19/2005
4/1/2017
Inactive
Folley, Marcia Kathleen
310687
Agent - Health
7/14/2004
4/1/2019
Inactive
Folley, Marcia Kathleen
310687
Agent - Life
7/14/2004
12/29/2011
Inactive
Frisbey, Ralph Michael
383887
Agent - Health
8/22/2006
4/3/2009
Inactive
Frisbey, Ralph Michael
383887
Agent - Life
8/22/2006
4/3/2009
Inactive
Frizzell, Donald Joe
370423
Agent - Health
2/6/2008
10/1/2023
Inactive
Frizzell, Donald Joe
370423
Agent - Life
2/6/2008
10/1/2023
Inactive
Frizzell, Trent Donald
602995
Agent - Health
2/6/2008
6/1/2012
Inactive
Frizzell, Trent Donald
602995
Agent - Life
2/6/2008
6/1/2012
Inactive
Goe, Robert Colin
381525
Agent - Health
3/26/2012
12/31/2015
Inactive
Goe, Robert Colin
381525
Agent - Life
3/26/2012
12/31/2015
Inactive
Gomez, Carmen Milagros
1299630
Agent - Health
3/20/2024
11/8/2024
Inactive
Gomez, Carmen Milagros
1299630
Agent - Life
3/20/2024
11/8/2024
Inactive
Gronefeld, Paul Edward
306192
Agent - Health
12/13/2007
4/30/2020
Inactive
Gronefeld, Paul Edward
306192
Agent - Life
12/13/2007
4/30/2020
Inactive
Hall, George Duane
365425
Agent - Health
6/14/2007
1/1/2020
Inactive
Hall, George Duane
365425
Agent - Life
6/14/2007
1/1/2020
Inactive
Hoffman, Lloyd Kenneth
385879
Agent - Health
1/12/2011
3/1/2022
Inactive
Hoffman, Lloyd Kenneth
385879
Agent - Life
1/12/2011
3/1/2022
Inactive
Hoffman, Richard Dean
348036
Agent - Health
8/22/2006
11/8/2024
Inactive
Hoffman, Richard Dean
348036
Agent - Life
8/22/2006
11/8/2024
Inactive
House, Brandon A
556056
Agent - Health
11/2/2006
11/8/2024
Inactive
House, Brandon A
556056
Agent - Life
11/2/2006
11/8/2024
Inactive
House, Danny Russell
350809
Agent - Health
4/11/2007
6/30/2020
Inactive
House, Danny Russell
350809
Agent - Life
4/11/2007
6/30/2020
Inactive
Johnson, Brandi Jil
620404
Agent - Health
10/14/2008
11/8/2024
Inactive
Johnson, Brandi Jil
620404
Agent - Life
10/14/2008
11/8/2024
Inactive
Kettenacker, Herb
344808
Agent - Health
8/10/2009
11/8/2024
Inactive
Kettenacker, Herb
344808
Agent - Life
8/10/2009
11/8/2024
Inactive
Kibler, James E
358016
Agent - Life
3/24/2014
3/20/2024
Inactive
Lambert, Frances Smith
353310
Agent - Health
10/11/2011
7/1/2013
Inactive
Lambert, Frances Smith
353310
Agent - Life
10/11/2011
7/1/2013
Inactive
Lykins, Alice
383327
Agent - Health
4/18/2008
4/1/2015
Inactive
Lykins, Alice
383327
Agent - Life
3/5/2008
4/1/2015
Inactive
Lykins, Donald Ray
383788
Agent - Health
1/19/2005
11/8/2024
Inactive
Lykins, Donald Ray
383788
Agent - Life
1/19/2005
11/8/2024
Inactive
Maupin, Joseph John
359096
Agent - Health
12/17/2007
10/1/2011
Inactive
Maupin, Joseph John
359096
Agent - Life
12/17/2007
10/1/2011
Inactive
McCarty, Ryan William
509976
Agent - Health
8/14/2009
11/8/2024
Inactive
McCarty, Ryan William
509976
Agent - Life
8/14/2009
11/8/2024
Inactive
McVeigh, Deborah Rae
335137
Agent - Health
1/19/2005
8/1/2022
Inactive
McVeigh, Deborah Rae
335137
Agent - Life
1/19/2005
8/1/2022
Inactive
Michaelides, Gale M
705237
Agent - Health
11/15/2010
5/31/2016
Inactive
Michaelides, Gale M
705237
Agent - Life
11/15/2010
5/31/2016
Inactive
Morgan, Dedria Lane
353403
Agent - Health
3/17/2010
11/8/2024
Inactive
Morgan, Dedria Lane
353403
Agent - Life
3/17/2010
11/8/2024
Inactive
Neely, Danny Steele
661089
Agent - Health
3/15/2010
11/8/2024
Inactive
Neely, Danny Steele
661089
Agent - Life
3/15/2010
11/8/2024
Inactive
Parks, Gary R
371614
Agent - Health
11/9/2009
11/7/2011
Inactive
Parks, Gary R
371614
Agent - Life
11/9/2009
8/31/2021
Inactive
Partin, Kelly
327295
Agent - Health
10/8/2007
11/8/2024
Inactive
Partin, Kelly
327295
Agent - Life
10/8/2007
11/8/2024
Inactive
Ralston, Jenny S
380175
Agent - Health
2/6/2008
8/31/2008
Inactive
Ralston, Jenny S
380175
Agent - Life
2/6/2008
8/31/2008
Inactive
Rankin, Michele Shryock
637778
Agent - Health
6/6/2008
8/1/2011
Inactive
Rankin, Michele Shryock
637778
Agent - Life
6/6/2008
8/1/2011
Inactive
Ritchie, Mark A
567125
Agent - Health
2/25/2004
4/30/2012
Inactive
Ritchie, Mark A
567125
Agent - Life
2/25/2004
4/30/2012
Inactive
Scudder, Douglas Ray
348382
Agent - Health
5/8/2012
2/28/2021
Inactive
Scudder, Douglas Ray
348382
Agent - Life
5/8/2012
2/28/2021
Inactive
Sheeran, Stephen Gregory
345367
Agent - Health
6/18/2008
9/15/2020
Inactive
Sheeran, Stephen Gregory
345367
Agent - Life
6/18/2008
11/8/2024
Inactive
Shryock, Elaine Cynthia
388148
Agent - Health
2/6/2008
2/1/2019
Inactive
Shryock, Elaine Cynthia
388148
Agent - Life
2/6/2008
2/1/2019
Inactive
Sowell, Bobby R
602534
Agent - Health
11/2/2006
11/30/2007
Inactive
Sowell, Bobby R
602534
Agent - Life
11/2/2006
11/30/2007
Inactive
Stoddard, Charles W
316319
Agent - Health
3/5/2008
6/18/2008
Inactive
Stoddard, Charles W
316319
Agent - Life
3/5/2008
6/18/2008
Inactive
Thompson, Ronald Gene
336566
Agent - Health
6/14/2007
3/19/2013
Inactive
Thompson, Ronald Gene
336566
Agent - Life
6/14/2007
3/19/2013
Inactive
Turner, Harvey Amos
391206
Agent - Health
12/10/2007
11/8/2024
Inactive
Turner, Harvey Amos
391206
Agent - Life
12/10/2007
11/8/2024
Inactive
Turner, Jacqueline
826781
Agent - Health
12/6/2013
9/30/2020
Inactive
Turner, Jacqueline
826781
Agent - Life
12/6/2013
9/30/2020
Inactive
Vancil, Rodney Dean
306467
Agent - Health
1/19/2005
11/8/2024
Inactive
Vancil, Rodney Dean
306467
Agent - Life
1/19/2005
11/8/2024
Inactive
Walker, Michael D
355946
Agent - Health
9/12/2007
11/8/2024
Inactive
Walker, Michael D
355946
Agent - Life
9/12/2007
11/8/2024
Inactive
Watts, Richard Allen
336200
Agent - Health
5/21/2007
2/28/2009
Inactive
Watts, Richard Allen
336200
Agent - Life
5/21/2007
2/28/2009
Inactive
Watts, Richard Michael
308664
Agent - Health
9/18/2007
6/29/2021
Inactive
Watts, Richard Michael
308664
Agent - Life
9/10/2007
11/8/2024
Inactive
Widger, Esther Faye
328683
Agent - Health
6/18/2008
7/31/2012
Inactive
Widger, Esther Faye
328683
Agent - Life
6/18/2008
7/31/2012
Inactive
Wilson, Judith Lynn
592973
Agent - Health
9/5/2008
11/8/2024
Inactive
Wilson, Judith Lynn
592973
Agent - Life
9/5/2008
11/8/2024
Inactive
Wright, Robert Andrew
350248
Agent - Health
11/2/2020
10/1/2022
Inactive
Wright, Robert Andrew
350248
Agent - Life
3/10/2008
10/1/2022
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