DEPARTMENT OF INSURANCE

Affiliations

Name	Mid Mountain Insurance Agency, LLC	DOIID	650001	NAIC NPN	1916108

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	2/7/2025	3/31/2027
Active	Non Resident	Agent	Health	3/5/2007	3/31/2027
Active	Non Resident	Agent	Life	3/5/2007	3/31/2027
Active	Non Resident	Agent	Casualty	2/7/2025	3/31/2027
Pending	Non Resident	Surplus Lines Broker	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	AXA XL Insurance Company Americas	300979	Agent - Health	3/30/2015	1/14/2020
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Inactive	Aetna Health Inc.	300694	Agent - Health	9/4/2007	12/31/2007
Active	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/6/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	9/4/2007
Active	Aetna Life Insurance Company	301140	Agent - Life	9/4/2007
Active	American General Life Insurance Company	301585	Agent - Health	3/15/2011
Active	American General Life Insurance Company	301585	Agent - Life	3/15/2011
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/30/2009
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	11/30/2009	10/16/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/30/2009	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/30/2009	4/15/2025
Inactive	Assurity Life Insurance Company	301099	Agent - Health	3/4/2011	12/20/2018
Inactive	Assurity Life Insurance Company	301099	Agent - Life	3/4/2011	12/20/2018
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	9/5/2007	3/1/2011
Inactive	Banner Life Insurance Company	301696	Agent - Life	5/16/2013	3/14/2025
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	8/3/2018
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	3/23/2025
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	7/26/2012	2/3/2025
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	7/26/2012	2/3/2025
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	6/8/2009	3/14/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Health	6/23/2009	7/2/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	6/23/2009	7/2/2013
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018
Active	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009
Inactive	Federal Insurance Company	301144	Agent - Health	6/20/2019	12/29/2021
Active	Golden Rule Insurance Company	301943	Agent - Health	3/14/2007
Active	Golden Rule Insurance Company	301943	Agent - Life	3/14/2007
Inactive	HCC Life Insurance Company	301827	Agent - Health	11/3/2016	6/12/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	7/10/2013	2/23/2018
Active	Humana Health Plan, Inc.	300142	Agent - Health	1/30/2008
Active	Humana Insurance Company	301104	Agent - Health	1/30/2008
Active	Humana Insurance Company	301104	Agent - Life	1/30/2008
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	1/30/2008
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	1/30/2008
Inactive	HumanaDental Insurance Company	301457	Agent - Health	1/30/2008	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	1/30/2008	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	10/22/2015
Active	National Health Insurance Company	300554	Agent - Health	12/14/2024
Active	National Health Insurance Company	300554	Agent - Life	12/14/2024
Inactive	Security Life Insurance Company of America	300936	Agent - Health	8/2/2007	3/24/2009
Inactive	Security Life Insurance Company of America	300936	Agent - Life	8/2/2007	3/24/2009
Active	SilverScript Insurance Company	663526	Agent - Health	1/2/2020
Active	Southern Financial Life Insurance Company	300664	Agent - Health	5/24/2013
Active	Southern Financial Life Insurance Company	300664	Agent - Life	5/24/2013
Active	Standard Insurance Company	300185	Agent - Health	1/3/2025
Active	Standard Insurance Company	300185	Agent - Life	1/3/2025
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	4/10/2017	12/27/2018
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	4/10/2017	12/27/2018
Inactive	Starr Indemnity and Liability Company	301685	Agent - Health	4/16/2012	8/16/2018
Inactive	Time Insurance Company	300683	Agent - Health	3/11/2007	11/15/2019
Inactive	Time Insurance Company	300683	Agent - Life	3/11/2007	11/15/2019
Inactive	Unified Life Insurance Company	543169	Agent - Health	8/10/2015	4/6/2018
Active	United States Fire Insurance Company	582240	Agent - Health	4/4/2018
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	3/23/2025
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	4/21/2008
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/16/2016	12/20/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/5/2019	12/22/2022
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/11/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/11/2015	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	12/23/2021
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	4/21/2008	11/29/2016
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	3/23/2025
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/25/2023	3/1/2025
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/25/2023	3/1/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Klemin, John R	812275	Agent - Health	12/3/2013	12/10/2024
Inactive	Klemin, John R	812275	Agent - Life	12/3/2013	12/10/2024
Inactive	Kobbe, Eric Scot	603781	Agent - Casualty	8/14/2024	12/10/2024
Inactive	Kobbe, Eric Scot	603781	Agent - Property	8/14/2024	12/10/2024
Inactive	Nichols, Shane Reed	639287	Agent - Health	10/20/2012	12/31/2014
Inactive	Nichols, Shane Reed	639287	Agent - Life	3/5/2007	12/31/2014
Active	Westlund, Brenda	1282429	Agent - Casualty	2/7/2025
Active	Westlund, Brenda	1282429	Agent - Health	12/4/2024
Active	Westlund, Brenda	1282429	Agent - Life	12/4/2024
Active	Westlund, Brenda	1282429	Agent - Property	2/7/2025