DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ely, Brian David	DOIID	611954	NAIC NPN	6767702

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/2/2018		11/30/2024
Active	Non Resident	Agent	Life	7/2/2018		11/30/2024
* 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	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	1/17/2023	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	1/17/2023
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	1/17/2023
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	8/27/2020
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	8/27/2020
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	3/31/2014	11/30/2014
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	3/31/2014	11/30/2014
Inactive	Continental American Insurance Company	301700	Agent - Health	1/17/2012	11/30/2014
Inactive	Continental American Insurance Company	301700	Agent - Life	1/17/2012	11/30/2014
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	1/17/2023
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	1/17/2023
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/26/2012	11/30/2014
Inactive	Humana Insurance Company	301104	Agent - Health	10/24/2012	11/30/2014
Inactive	Humana Insurance Company	301104	Agent - Life	10/24/2012	11/30/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/26/2012	11/30/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/26/2012	11/30/2014
Active	Tier One Insurance Company	301056	Agent - Health	8/30/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	PCF Insurance Services Of The West, LLC	976137	Agent - Life	7/18/2022
Active	PCF Insurance Services Of The West, LLC	976137	Agent - Health	7/18/2022
Inactive	VBW Insurance Services, Inc	836941	Agent - Life	3/27/2014	11/30/2014
Inactive	VBW Insurance Services, Inc	836941	Agent - Health	3/27/2014	11/30/2014