DEPARTMENT OF INSURANCE

Affiliations

Name	Chavious, Glenn T	DOIID	561726	NAIC NPN	2299110

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	12/12/2002		6/30/2026
Active	Non Resident	Agent	Casualty	12/12/2002		6/30/2026
Active	Non Resident	Agent	Life	5/27/2003		6/30/2026
Active	Non Resident	Agent	Health	5/27/2003		6/30/2026
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	4/15/2014	8/15/2019
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2024	06/30/2024	05/29/2024	05/29/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	7/19/2023
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	7/19/2023
Active	Anthem Life Insurance Company	301209	Agent - Health	4/7/2023
Active	Anthem Life Insurance Company	301209	Agent - Life	4/7/2023
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/28/2011	12/10/2012
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/28/2011	12/10/2012
Inactive	Federal Insurance Company	301144	Agent - Casualty	7/21/2003	7/27/2004
Inactive	Federal Insurance Company	301144	Agent - Property	7/21/2003	7/27/2004
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	11/24/2012	12/17/2014
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	11/24/2012	12/17/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/28/2011	12/10/2012
Inactive	Humana Insurance Company	301104	Agent - Health	3/28/2011	12/10/2012
Inactive	Humana Insurance Company	301104	Agent - Life	3/28/2011	12/10/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/28/2011	12/10/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/28/2011	12/10/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Health	3/17/2012	12/14/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	3/17/2012	12/14/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/28/2011	12/10/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/28/2011	12/10/2012
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	12/18/2012
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	1/17/2013	12/17/2014
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	1/17/2013	12/17/2014
Active	Wellpoint Life and Health Insurance Company	300469	Agent - Health	4/6/2023
Active	Wellpoint Life and Health Insurance Company	300469	Agent - Life	4/6/2023
Inactive	West Coast Life Insurance Company	301607	Agent - Life	9/30/2003	12/8/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Altus Specialty Group LLC	755301	Agent - Casualty	5/31/2011	3/31/2015
Inactive	Altus Specialty Group LLC	755301	Agent - Property	5/31/2011	3/31/2015
Inactive	Altus Specialty Group LLC	755301	Agent - Health	5/31/2011	3/31/2015
Inactive	Altus Specialty Group LLC	755301	Agent - Life	5/31/2011	3/31/2015
Inactive	Arthur J. Gallagher and Co. of Massachusetts, Inc.	583479	Agent - Casualty	1/23/2004	7/27/2004
Inactive	Arthur J. Gallagher and Co. of Massachusetts, Inc.	583479	Agent - Property	1/23/2004	7/27/2004
Inactive	Arthur J. Gallagher and Co. of Massachusetts, Inc.	583479	Agent - Life	1/23/2004	12/31/2005
Active	Escalon Insurance Services LLC	1296973	Agent - Casualty	9/7/2023
Active	Escalon Insurance Services LLC	1296973	Agent - Property	9/7/2023
Active	Escalon Insurance Services LLC	1296973	Agent - Health	9/7/2023
Active	Escalon Insurance Services LLC	1296973	Agent - Life	9/7/2023
Inactive	Industria Risk & Insurance Services LLC	987150	Agent - Casualty	3/13/2018	6/13/2019
Inactive	Industria Risk & Insurance Services LLC	987150	Agent - Property	3/13/2018	6/13/2019
Inactive	Industria Risk & Insurance Services LLC	987150	Agent - Health	3/13/2018	6/13/2019
Inactive	Industria Risk & Insurance Services LLC	987150	Agent - Life	3/13/2018	6/13/2019
Inactive	Industria Risk & Insurance Services LLC	987150	Surplus Lines Broker - Not Applicable	3/13/2018	8/15/2019
Inactive	Ingenium Specialty Programs, LLC	1040664	Agent - Casualty	5/20/2019	8/20/2019
Inactive	Ingenium Specialty Programs, LLC	1040664	Agent - Property	5/20/2019	8/20/2019
Inactive	Ingenium Specialty Programs, LLC	1040664	Agent - Health	5/20/2019	8/20/2019
Inactive	Ingenium Specialty Programs, LLC	1040664	Agent - Life	5/20/2019	8/20/2019
Inactive	Intercontinental Holdings Llc	751460	Agent - Casualty	4/23/2014	3/31/2017
Inactive	Intercontinental Holdings Llc	751460	Agent - Property	4/23/2014	3/31/2017
Inactive	Intercontinental Holdings Llc	751460	Agent - Health	2/27/2013	3/31/2017
Denied	Intercontinental Holdings Llc	751460	Agent - Life
Inactive	Intercontinental Holdings Llc	751460	Surplus Lines Broker - Not Applicable	4/23/2014	3/31/2017
Inactive	Profound Insurance Programs, LLC	1058520	Agent - Casualty	10/3/2019	3/26/2024
Inactive	Profound Insurance Programs, LLC	1058520	Agent - Property	10/3/2019	3/26/2024
Inactive	Profound Insurance Programs, LLC	1058520	Agent - Health	10/3/2019	3/26/2024
Inactive	Profound Insurance Programs, LLC	1058520	Agent - Life	10/3/2019	3/26/2024