DEPARTMENT OF INSURANCE

Affiliations

Name	Borella, Matthew L	DOIID	565317	NAIC NPN	7069134

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	12/10/2024	2/28/2027
Active	Non Resident	Agent	Health	8/1/2023	2/28/2027
Active	Non Resident	Agent	Life	8/1/2023	2/28/2027
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	1/17/2011	2/28/2011
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	1/17/2011	2/28/2011
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Health	7/25/2003	2/28/2011
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Life	7/25/2003	2/28/2011
Inactive	HM Life Insurance Company	301408	Agent - Health	2/21/2007	2/28/2011
Inactive	HM Life Insurance Company	301408	Agent - Life	2/21/2007	2/28/2011
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/7/2008	2/28/2011
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/7/2008	2/28/2011
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	12/29/2023
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	12/29/2023
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	7/22/2003	2/28/2011
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	7/22/2003	2/28/2011
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Health	7/22/2003	6/25/2008
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Life	7/22/2003	6/25/2008
Active	Starmount Life Insurance Company	628031	Agent - Health	8/4/2023
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	2/21/2007	2/28/2011
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	2/21/2007	2/28/2011
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	2/21/2007	10/1/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	2/21/2007	10/1/2008
Inactive	Trustmark Insurance Company	300317	Agent - Health	2/4/2007	2/24/2011
Inactive	Trustmark Insurance Company	300317	Agent - Life	2/4/2007	2/24/2011
Active	UNUM Life Insurance Company of America	300817	Agent - Health	8/4/2023
Active	UNUM Life Insurance Company of America	300817	Agent - Life	8/4/2023
Active	Unum Insurance Company	301499	Agent - Health	8/4/2023
Active	Unum Insurance Company	301499	Agent - Life	8/4/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Premier Work-Site Solutions, LLC	1376433	Administrator - Not Applicable	12/12/2024
Inactive	The Farmington Company	534046	Agent - Health	7/25/2003	2/28/2011
Inactive	The Farmington Company	534046	Agent - Life	7/25/2003	2/28/2011