DEPARTMENT OF INSURANCE

Affiliations

Name	Sidebottom, Douglas Anthony	DOIID	581157	NAIC NPN	7907125

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	11/25/2003	6/30/2027
Active	Non Resident	Agent	Life	11/25/2003	6/30/2027
* 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	04/15/2025	06/30/2025	05/01/2025	05/01/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	5/14/2010	10/21/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Health	5/14/2010	10/21/2012
Inactive	Aetna Life Insurance Company	301140	Agent - Life	5/14/2010	10/21/2012
Active	American United Life Insurance Company	300498	Agent - Health	12/2/2009
Active	American United Life Insurance Company	300498	Agent - Life	12/2/2009
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/31/2025
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	2/27/2013	6/16/2022
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	2/27/2013	6/16/2022
Active	Citizens Security Life Insurance Company	301257	Agent - Health	6/3/2009
Active	Colonial Life and Accident Insurance Company	300846	Agent - Health	11/24/2014
Active	Colonial Life and Accident Insurance Company	300846	Agent - Life	11/24/2014
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/18/2013	12/8/2015
Inactive	CompBenefits Insurance Company	301864	Agent - Health	7/29/2020	12/15/2020
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	4/29/2022	12/12/2024
Active	Guardian Life Insurance Company of America	301316	Agent - Health	2/27/2013
Active	Guardian Life Insurance Company of America	301316	Agent - Life	2/27/2013
Active	HCC Life Insurance Company	301827	Agent - Health	4/28/2019
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	9/20/2013
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	9/20/2013
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	4/1/2021	12/12/2024
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	4/1/2021	12/12/2024
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/1/2021	12/12/2024
Inactive	Humana Insurance Company	301104	Agent - Health	4/1/2021	12/12/2024
Inactive	Humana Insurance Company	301104	Agent - Life	7/15/2019	12/19/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	4/1/2021	12/12/2024
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	4/1/2021	12/12/2024
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	4/1/2021	12/12/2024
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	4/1/2021	12/12/2024
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/4/2013	1/22/2018
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/4/2013	1/22/2018
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Health	7/2/2009	8/22/2011
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Life	7/2/2009	8/22/2011
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Health	7/2/2009	8/22/2011
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Life	7/2/2009	8/22/2011
Active	United of Omaha Life Insurance Company	300156	Agent - Health	5/31/2017
Active	United of Omaha Life Insurance Company	300156	Agent - Life	5/31/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Assuredpartners NL, LLC	762387	Agent - Life	4/27/2018
Active	Assuredpartners NL, LLC	762387	Agent - Health	4/27/2018
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/9/2013	2/17/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/9/2013	2/17/2025
Inactive	Hartfield Company, Inc. [The]	515823	Agent - Life	4/27/2009	3/31/2020
Inactive	Hartfield Company, Inc. [The]	515823	Agent - Health	4/27/2009	3/31/2020