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	6/30/2025
Active	Non Resident	Agent	Life	11/25/2003	6/30/2025
* 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	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
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
Active	Dental Concern Inc. (The)	301641	Agent - Health	4/29/2022
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
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	4/1/2021
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	4/1/2021
Active	Humana Health Plan, Inc.	300142	Agent - Health	4/1/2021
Active	Humana Insurance Company	301104	Agent - Health	4/1/2021
Inactive	Humana Insurance Company	301104	Agent - Life	7/15/2019	12/19/2019
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	4/1/2021
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	4/1/2021
Active	Humana Medical Plan, Inc.	801568	Agent - Health	4/1/2021
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	4/1/2021
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
Active	Designated Agent Company Inc.	681257	Agent - Life	12/9/2013
Active	Designated Agent Company Inc.	681257	Agent - Health	12/9/2013
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