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DEPARTMENT OF INSURANCE
Affiliations
Name
Diebold, Mona
DOIID
556175
NAIC NPN
6516907
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Non Resident
Agent
Casualty
10/11/2007
9/20/2022
Inactive
Non Resident
Agent
Health
9/26/2002
9/20/2022
Inactive
Non Resident
Agent
Property
10/11/2007
9/20/2022
Inactive
Non Resident
Agent
Life
9/26/2002
9/20/2022
Inactive
Non Resident
Agent
Variable Life and Variable Annuities
9/26/2002
9/20/2022
* If a status Is
Pending, Pending Replacement
,Or the record displays
Affidavit On File
, click On them For more details.
Notice:
The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
21st Century North America Insurance Company
300884
Agent - Casualty
4/15/2008
11/17/2008
Inactive
21st Century North America Insurance Company
300884
Agent - Property
4/15/2008
11/17/2008
Inactive
Central States Health and Life Company of Omaha
301874
Agent - Health
10/3/2003
8/15/2005
Inactive
Central States Health and Life Company of Omaha
301874
Agent - Life
10/3/2003
8/15/2005
Inactive
CompBenefits Dental, Inc.
591692
Agent - Health
10/12/2012
12/10/2012
Inactive
Dental Concern Inc. (The)
301641
Agent - Health
10/12/2012
12/10/2012
Inactive
First Colony Life Insurance Company
301179
Agent - Health
8/14/2003
1/1/2007
Inactive
First Colony Life Insurance Company
301179
Agent - Life
8/14/2003
1/1/2007
Inactive
Genworth Life Insurance Company
300623
Agent - Health
9/27/2006
12/14/2016
Inactive
Genworth Life Insurance Company
300623
Agent - Life
9/27/2006
12/14/2016
Inactive
Genworth Life and Annuity Insurance Company
301276
Agent - Health
1/1/2007
12/14/2016
Inactive
Genworth Life and Annuity Insurance Company
301276
Agent - Life
1/1/2007
12/14/2016
Inactive
Humana Benefit Plan of Illinois, Inc.
781543
Agent - Health
11/17/2014
12/19/2019
Inactive
Humana Health Plan of Ohio Inc.
301565
Agent - Health
10/12/2012
1/17/2014
Inactive
Humana Health Plan, Inc.
300142
Agent - Health
10/7/2007
12/10/2012
Inactive
Humana Insurance Company
301104
Agent - Health
1/11/2017
12/19/2019
Inactive
Humana Insurance Company
301104
Agent - Life
10/12/2012
1/17/2014
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Health
10/7/2007
1/17/2014
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Life
10/7/2007
1/17/2014
Inactive
Humana Medical Plan, Inc.
801568
Agent - Health
11/17/2014
12/19/2019
Inactive
Humana Wisconsin Health Organization Insurance Corporation
830687
Agent - Health
10/12/2016
12/19/2019
Inactive
Jackson National Life Insurance Company
300486
Agent - Life
10/27/2005
6/23/2010
Inactive
John Alden Life Insurance Company
300573
Agent - Health
11/30/2005
7/16/2013
Inactive
John Alden Life Insurance Company
300573
Agent - Life
11/30/2005
7/16/2013
Inactive
John Hancock Life Insurance Company
300821
Agent - Health
1/1/2003
12/30/2009
Inactive
John Hancock Life Insurance Company (U.S.A.)
300132
Agent - Health
9/19/2008
6/8/2011
Inactive
John Hancock Life Insurance Company (U.S.A.)
300132
Agent - Life
1/28/2004
6/8/2011
Inactive
John Hancock Life Insurance Company (U.S.A.)
300132
Agent - Variable Life and Variable Annuities
1/28/2004
6/8/2011
Inactive
MetLife Investors USA Insurance Company
300845
Agent - Health
1/19/2007
11/19/2009
Inactive
MetLife Investors USA Insurance Company
300845
Agent - Life
1/19/2007
11/19/2009
Inactive
Metropolitan Life Insurance Company
301948
Agent - Health
3/17/2004
11/26/2009
Inactive
Metropolitan Life Insurance Company
301948
Agent - Life
3/17/2004
11/26/2009
Inactive
National Guardian Life Insurance Company
300596
Agent - Health
12/29/2005
9/20/2022
Inactive
National Guardian Life Insurance Company
300596
Agent - Life
12/29/2005
9/20/2022
Inactive
Physicians Mutual Insurance Company
301084
Agent - Health
1/22/2004
12/13/2006
Inactive
Principal Life Insurance Company
300129
Agent - Health
8/23/2004
12/3/2008
Inactive
Principal Life Insurance Company
300129
Agent - Life
8/23/2004
12/3/2008
Inactive
Sun Life Assurance Company of Canada
301811
Agent - Life
12/24/2003
12/13/2006
Inactive
Thrivent Financial for Lutherans
301101
Agent - Health
9/26/2002
9/20/2022
Inactive
Thrivent Financial for Lutherans
301101
Agent - Life
9/26/2002
9/20/2022
Inactive
Thrivent Financial for Lutherans
301101
Agent - Variable Life and Variable Annuities
9/26/2002
9/20/2022
Inactive
Time Insurance Company
300683
Agent - Health
6/27/2014
11/23/2019
Inactive
Time Insurance Company
300683
Agent - Life
6/27/2014
11/23/2019
Inactive
Venerable Insurance and Annuity Company
301006
Agent - Life
9/2/2004
11/3/2007
Inactive
Venerable Insurance and Annuity Company
301006
Agent - Variable Life and Variable Annuities
9/2/2004
11/3/2007
Inactive
West Coast Life Insurance Company
301607
Agent - Health
10/30/2003
12/29/2005
Inactive
West Coast Life Insurance Company
301607
Agent - Life
10/30/2003
12/29/2005
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Thrivent Ins Agency Inc
510973
Agent - Health
1/23/2003
9/20/2022
Inactive
Thrivent Ins Agency Inc
510973
Agent - Life
1/3/2003
9/20/2022
Inactive
Thrivent Ins Agency Inc
510973
Agent - Variable Life and Variable Annuities
7/13/2004
9/20/2022
Inactive
Thrivent Ins Agency Inc
510973
Agent - Property
7/29/2020
9/20/2022
Inactive
Thrivent Ins Agency Inc
510973
Agent - Casualty
7/29/2020
9/20/2022
Inactive
Thrivent Property & Casualty Insurance Agency Inc
515095
Agent - Property
4/15/2008
11/17/2008
Inactive
Thrivent Property & Casualty Insurance Agency Inc
515095
Agent - Casualty
4/15/2008
11/17/2008
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