DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burnside, Ellen S	DOIID	601715	NAIC NPN	8373931

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	2/10/2005	6/1/2023
Inactive	Resident	Agent	Life	2/10/2005	6/1/2023
Denied	Resident	Life & Health Consultant	Not Applicable
* 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	Anthem Life Insurance Company	301209	Agent - Health	6/10/2014	6/1/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/10/2014	6/1/2023
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/23/2013	4/14/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	7/23/2013	4/14/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/14/2005	4/14/2014
Inactive	Humana Insurance Company	301104	Agent - Health	3/14/2005	4/14/2014
Inactive	Humana Insurance Company	301104	Agent - Life	3/14/2005	4/14/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/14/2005	4/14/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/14/2005	4/14/2014
Inactive	HumanaDental Insurance Company	301457	Agent - Health	8/21/2006	2/22/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	8/21/2006	2/22/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	4/14/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	4/14/2014
Inactive	Pacific Life Insurance Company	301848	Agent - Life	5/5/2008	12/8/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Benefit Ins Marketing Inc	398449	Agent - Health	6/10/2014	6/1/2023
Inactive	Benefit Ins Marketing Inc	398449	Agent - Life	7/1/2005	6/1/2023
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/10/2014	6/1/2023
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/16/2013	6/1/2023