DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Legacy Benefits Solutions, LLC	DOIID	627476	NAIC NPN	8575686

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	3/14/2006	3/8/2010
Inactive	Non Resident	Agent	Health	3/14/2006	3/8/2010
* 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 Health Plans of Kentucky, Inc.	300999	Agent - Health	5/19/2006	3/8/2010
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	5/19/2006	3/8/2010
Inactive	Anthem Life Insurance Company	301209	Agent - Health	5/19/2006	3/8/2010
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/19/2006	3/8/2010
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/17/2007	3/8/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/28/2006	3/8/2010
Inactive	Humana Insurance Company	301104	Agent - Health	3/28/2006	3/8/2010
Inactive	Humana Insurance Company	301104	Agent - Life	3/28/2006	3/8/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/28/2006	3/8/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/28/2006	3/8/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Health	9/17/2007	3/8/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Life	9/17/2007	3/8/2010
Inactive	John Alden Life Insurance Company	300573	Agent - Health	3/11/2008	3/8/2010
Inactive	John Alden Life Insurance Company	300573	Agent - Life	3/11/2008	3/8/2010
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	10/18/2009	3/5/2010
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	1/9/2007	3/5/2010
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	1/9/2007	3/8/2010
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	1/9/2007	3/8/2010
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	1/9/2007	3/5/2010

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bloomer, Carl R	601550	Agent - Health	2/11/2008	3/8/2010
Inactive	Bloomer, Carl R	601550	Agent - Life	2/11/2008	3/8/2010
Inactive	Pascarella, Dennis E	308112	Agent - Health	4/13/2007	2/11/2008
Inactive	Pascarella, Dennis E	308112	Agent - Life	4/13/2007	2/11/2008