DEPARTMENT OF INSURANCE

Affiliations

Name	Matlak, Kevin Michael	DOIID	565034	NAIC NPN	7569656

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	2/28/2003	9/30/2024
Active	Non Resident	Agent	Life	2/28/2003	9/30/2024
* 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	07/15/2024	09/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	9/27/2018
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/27/2018
Active	American General Life Insurance Company	301585	Agent - Health	7/16/2011
Active	American General Life Insurance Company	301585	Agent - Life	7/16/2011
Inactive	Assurity Life Insurance Company	301099	Agent - Health	3/6/2013	12/9/2014
Inactive	Assurity Life Insurance Company	301099	Agent - Life	3/6/2013	12/9/2014
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	10/31/2010	12/1/2010
Inactive	Balboa Life Insurance Company	301327	Agent - Health	12/15/2004	6/27/2005
Inactive	Balboa Life Insurance Company	301327	Agent - Life	12/15/2004	6/27/2005
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	11/14/2014	10/29/2015
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	9/28/2005	4/1/2007
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	9/28/2005	4/1/2007
Active	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	1/25/2007
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Health	5/21/2004	6/14/2006
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Life	5/21/2004	6/14/2006
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	10/18/2011	11/14/2014
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	10/20/2021	12/29/2021
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	6/23/2015	4/22/2019
Inactive	Protective Life Insurance Company	300638	Agent - Health	4/1/2007	12/17/2010
Inactive	Protective Life Insurance Company	300638	Agent - Life	4/1/2007	12/17/2010
Active	Pruco Life Insurance Company	300954	Agent - Health	2/6/2008
Active	Pruco Life Insurance Company	300954	Agent - Life	2/6/2008
Inactive	Revol One Insurance Company	300681	Agent - Health	3/4/2008	12/28/2012
Inactive	Revol One Insurance Company	300681	Agent - Life	3/4/2008	5/31/2012
Inactive	Symetra Life Insurance Company	301691	Agent - Health	2/4/2013	9/16/2014
Inactive	Symetra Life Insurance Company	301691	Agent - Life	2/4/2013	9/16/2014
Inactive	United World Life Insurance Company	300532	Agent - Health	10/20/2021	12/29/2021
Active	United of Omaha Life Insurance Company	300156	Agent - Health	12/30/2021
Active	United of Omaha Life Insurance Company	300156	Agent - Life	12/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	America Direct Ins Agency Inc	619155	Agent - Health	1/23/2007	3/31/2010
Inactive	America Direct Ins Agency Inc	619155	Agent - Life	1/23/2007	3/31/2010
Active	Efinancial LLC	598419	Agent - Health	1/14/2010
Active	Efinancial LLC	598419	Agent - Life	1/14/2010