DEPARTMENT OF INSURANCE
Affiliations
NameInsurance Product Development Group, LCDOIID585528NAIC NPN8013377
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth4/26/2004 3/31/2028
ActiveNon ResidentAgentLife4/26/2004 3/31/2028
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAccendo Insurance Company300312Agent - Life7/29/202012/19/2025
ActiveAetna Health Inc. (PA)660717Agent - Health9/24/2019 
InactiveAetna Health and Life Insurance Company300523Agent - Health7/29/202012/19/2025
ActiveAetna Health of Ohio Inc.1065035Agent - Health7/24/2020 
ActiveAetna Life Insurance Company301140Agent - Health2/19/2020 
InactiveCIGNA Health & Life Insurance Company301783Agent - Health11/15/20224/29/2026
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health1/3/2024 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health3/6/2018 
ActiveCoventry Health and Life Insurance Company301771Agent - Health1/24/2011 
ActiveEquiTrust Life Insurance Company502870Agent - Life4/13/2009 
ActiveFirst Health Life & Health Insurance Company301735Agent - Health1/24/2011 
ActiveHealthspring Healthcare of Colorado, Inc.1098153Agent - Health11/15/2022 
ActiveHealthspring Healthcare of Colorado, Inc.1098153Agent - Life11/15/2022 
ActiveSierra Health and Life Insurance Company Inc.300357Agent - Health11/12/2024 
ActiveSilverScript Insurance Company663526Agent - Health1/9/2020 
ActiveUnitedHealthcare Insurance Company300946Agent - Health1/3/2024 
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health3/13/202212/22/2022
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health1/3/2024 
InactiveWellCare Prescription Insurance Inc.654329Agent - Health3/8/20195/13/2021
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveGraham, Mark Burnside 638756Agent - Health4/13/20186/17/2022
InactiveGraham, Mark Burnside 638756Agent - Life4/13/20186/17/2022
InactiveGraham, Mark Burnside 638756Agent - Life4/13/20186/17/2022
ActiveGraham, Matthew B 640480Agent - Health6/17/2022 
ActiveGraham, Matthew B 640480Agent - Life6/17/2022 
InactiveNorth, Timothy Owen 514133Agent - Health4/26/20044/13/2018
InactiveNorth, Timothy Owen 514133Agent - Life4/26/20044/13/2018

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