DEPARTMENT OF INSURANCE
Affiliations
NameNational Benefits Brokerage, LLCDOIID615215NAIC NPN8561402
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife9/6/2005 3/31/2027
ActiveNon ResidentAgentHealth9/6/2005 3/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202503/31/202501/16/202501/16/2025Yes
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAccendo Insurance Company300312Agent - Health9/10/202111/17/2023
ActiveAccendo Insurance Company300312Agent - Life6/10/2020 
ActiveAetna Health Inc. (PA)660717Agent - Health9/18/2008 
ActiveAetna Health of Ohio Inc.1065035Agent - Health8/6/2020 
ActiveAetna Life Insurance Company301140Agent - Health9/18/2008 
ActiveAetna Life Insurance Company301140Agent - Life9/18/2008 
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Health11/1/200610/13/2014
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Life11/1/200610/13/2014
InactiveAmeritas Life Insurance Corporation300126Agent - Health10/2/20171/8/2024
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health11/10/2005 
InactiveAnthem Health Plans of New Hampshire, Inc.944064Agent - Health9/17/202112/19/2024
ActiveAnthem Insurance Companies, Inc.300941Agent - Health6/12/2021 
ActiveAnthem Life Insurance Company301209Agent - Health11/1/2005 
ActiveAnthem Life Insurance Company301209Agent - Life11/1/2005 
InactiveArcadian Health Plan, Inc.728196Agent - Health6/12/201810/1/2018
ActiveBanner Life Insurance Company301696Agent - Life4/23/2007 
InactiveBerkshire Life Insurance Company of America300983Agent - Health3/27/201910/5/2021
InactiveBerkshire Life Insurance Company of America300983Agent - Life3/27/201910/5/2021
InactiveCHA HMO, Inc.300662Agent - Health11/8/200512/10/2012
ActiveCIGNA Health & Life Insurance Company301783Agent - Health10/18/2022 
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health7/20/2022 
ActiveCigna Healthcare of Colorado, Inc.1098153Agent - Health10/20/2022 
InactiveCompBenefits Dental, Inc.591692Agent - Health4/4/200912/8/2015
InactiveCompBenefits Insurance Company301864Agent - Health4/4/20097/2/2013
InactiveCompBenefits Insurance Company301864Agent - Life4/4/20097/2/2013
ActiveCompcare Health Services Insurance Corporation948751Agent - Health9/25/2021 
InactiveConseco Health Insurance Company301725Agent - Health3/18/200910/1/2010
InactiveConseco Health Insurance Company301725Agent - Life3/18/200910/1/2010
InactiveConseco Insurance Company301202Agent - Health3/18/200910/1/2010
InactiveConseco Insurance Company301202Agent - Life3/18/200910/1/2010
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health3/6/2018 
Pending ReplacementDental Care Plus Inc.301495Agent - Health11/18/2005 
InactiveDental Concern Inc. (The)301641Agent - Health11/23/200512/8/2015
InactiveEmpower Annuity Insurance Company of America300259Agent - Health2/8/20062/19/2007
InactiveEmpower Annuity Insurance Company of America300259Agent - Life2/8/20062/19/2007
InactiveFidelity Security Life Insurance Company300466Agent - Health6/3/20132/22/2019
InactiveFidelity Security Life Insurance Company300466Agent - Life6/3/20132/22/2019
ActiveFirst Health Life & Health Insurance Company301735Agent - Health11/18/2014 
InactiveGerber Life Insurance Company300529Agent - Health6/8/20153/28/2016
InactiveGerber Life Insurance Company300529Agent - Life6/8/20153/28/2016
InactiveGolden Rule Insurance Company301943Agent - Health10/12/20096/15/2012
InactiveGolden Rule Insurance Company301943Agent - Life10/12/20096/15/2012
InactiveGuardian Life Insurance Company of America301316Agent - Health2/3/200611/15/2013
InactiveGuardian Life Insurance Company of America301316Agent - Life2/3/200611/15/2013
ActiveHartford Life and Accident Insurance Company300878Agent - Health5/5/2006 
ActiveHartford Life and Accident Insurance Company300878Agent - Life5/5/2006 
InactiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health6/12/201810/1/2018
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health4/22/20135/2/2017
InactiveHumana Health Plan, Inc.300142Agent - Health6/12/201810/1/2018
InactiveHumana Insurance Company301104Agent - Health6/12/201810/1/2018
InactiveHumana Insurance Company301104Agent - Life6/12/201810/1/2018
InactiveHumana Insurance Company of Kentucky300826Agent - Health6/12/201810/1/2018
InactiveHumana Insurance Company of Kentucky300826Agent - Life6/12/201810/1/2018
InactiveHumana Medical Plan, Inc.801568Agent - Health6/12/201810/1/2018
InactiveHumana Wisconsin Health Organization Insurance Corporation830687Agent - Health6/12/201810/1/2018
InactiveHumanaDental Insurance Company301457Agent - Health11/23/20055/13/2013
InactiveHumanaDental Insurance Company301457Agent - Life11/23/20055/13/2013
InactiveJohn Alden Life Insurance Company300573Agent - Health5/17/20073/20/2013
InactiveJohn Alden Life Insurance Company300573Agent - Life5/17/20073/20/2013
InactiveKanawha Insurance Company300127Agent - Health4/11/200810/14/2016
InactiveKanawha Insurance Company300127Agent - Life4/11/200810/14/2016
InactiveLincoln National Life Insurance Company (The)301382Agent - Health3/13/20083/29/2011
InactiveLincoln National Life Insurance Company (The)301382Agent - Life3/13/20083/29/2011
ActiveMedco Containment Life Insurance Company301557Agent - Health11/19/2024 
ActiveMetropolitan Life Insurance Company301948Agent - Health11/7/2005 
ActiveMetropolitan Life Insurance Company301948Agent - Life11/7/2005 
InactiveNew York Life Insurance Company300431Agent - Health9/10/20129/7/2017
InactiveNew York Life Insurance Company300431Agent - Life9/10/20129/7/2017
InactivePacifiCare Life and Health Insurance Company301304Agent - Health3/26/200911/3/2011
InactivePacifiCare Life and Health Insurance Company301304Agent - Life3/26/20097/17/2012
InactiveProvident Life and Accident Insurance Company301525Agent - Health10/24/20059/9/2015
InactiveProvident Life and Accident Insurance Company301525Agent - Life10/24/20059/9/2015
ActiveReliance Standard Life Insurance Company300584Agent - Health5/29/2011 
ActiveReliance Standard Life Insurance Company300584Agent - Life5/29/2011 
ActiveSilverScript Insurance Company663526Agent - Health10/19/2019 
InactiveStandard Insurance Company300185Agent - Health9/9/200512/5/2022
InactiveStandard Insurance Company300185Agent - Life9/9/200512/5/2022
ActiveSun Life Assurance Company of Canada301811Agent - Health2/8/2021 
ActiveSun Life Assurance Company of Canada301811Agent - Life2/8/2021 
Pending ReplacementSuperior Dental Care Inc.300418Agent - Health10/1/2015 
InactiveTime Insurance Company300683Agent - Health8/9/201212/20/2014
InactiveTime Insurance Company300683Agent - Life8/9/201212/20/2014
InactiveUNUM Life Insurance Company of America300817Agent - Health10/24/20059/9/2015
InactiveUNUM Life Insurance Company of America300817Agent - Life10/24/20059/9/2015
InactiveUnion Security Insurance Company301844Agent - Health2/28/20061/8/2021
InactiveUnion Security Insurance Company301844Agent - Life2/28/20061/8/2021
InactiveUnited States Life Insurance Company in the City of New York301126Agent - Health3/2/20067/29/2009
InactiveUnited States Life Insurance Company in the City of New York301126Agent - Life3/2/20067/29/2009
ActiveUnitedHealthcare Insurance Company300946Agent - Health4/23/2015 
ActiveUnitedHealthcare Insurance Company300946Agent - Life4/23/2015 
InactiveUnitedHealthcare Insurance Company of America301552Agent - Health9/11/201612/20/2018
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health8/5/201912/22/2022
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health7/15/201812/23/2021
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health6/1/202312/17/2024
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health9/10/2015 
InactiveWashington National Insurance Company300587Agent - Health10/1/20101/18/2012
InactiveWashington National Insurance Company300587Agent - Life10/1/20101/18/2012
InactiveWellCare Prescription Insurance Inc.654329Agent - Health12/11/20185/13/2021
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveBales, Melissa M 670561Agent - Health11/2/2009 
ActiveBales, Melissa M 670561Agent - Life11/2/2009 
InactiveCarnohan, David A 376050Agent - Health9/6/20057/1/2013
InactiveCarnohan, David A 376050Agent - Life9/6/20057/1/2013
ActiveCarnohan, Derek David 317580Agent - Health11/9/2009 
ActiveCarnohan, Derek David 317580Agent - Life11/9/2009 
ActiveDemler, Jeanne L 557615Agent - Health12/12/2008 
ActiveDemler, Jeanne L 557615Agent - Life12/12/2008 
InactiveDuerk, Gerald E 379575Agent - Health11/23/200910/31/2022
InactiveDuerk, Gerald E 379575Agent - Life10/31/201410/31/2022
InactiveGollahon, Frances Carole 540278Agent - Health11/9/20094/1/2013
InactiveGollahon, Frances Carole 540278Agent - Life11/9/20094/1/2013
ActiveGoodwin, Todd Alan 338131Agent - Health10/7/2011 
ActiveGoodwin, Todd Alan 338131Agent - Life10/7/2011 
InactiveHurst, Robert Wayne 365403Agent - Health5/4/20104/30/2014
InactiveHurst, Robert Wayne 365403Agent - Life5/4/20104/30/2014
InactiveLocy, Charles H 327960Agent - Health1/13/20112/12/2014
InactiveLocy, Charles H 327960Agent - Life1/13/20119/30/2016
InactiveMaslow, Arnold Michael 350065Agent - Health12/2/20056/30/2021
InactiveMaslow, Arnold Michael 350065Agent - Life12/2/20056/30/2021
ActiveTye, Roscoe E 338793Agent - Health7/29/2010 
ActiveTye, Roscoe E 338793Agent - Life7/29/2010 

© Commonwealth of Kentucky. All rights reserved.