DEPARTMENT OF INSURANCE
Affiliations
NameMid Mountain Insurance Agency, LLCDOIID650001NAIC NPN1916108
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentProperty2/7/2025 3/31/2027
ActiveNon ResidentAgentCasualty2/7/2025 3/31/2027
ActiveNon ResidentAgentLife3/5/2007 3/31/2027
ActiveNon ResidentAgentHealth3/5/2007 3/31/2027
ActiveNon ResidentSurplus Lines BrokerNot Applicable7/25/2025 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
Agent01/15/202703/31/2027   
Surplus Lines Broker01/15/202703/31/2027   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAXA XL Insurance Company Americas300979Agent - Health3/30/20151/14/2020
InactiveAccendo Insurance Company300312Agent - Life6/10/202012/19/2025
InactiveAetna Health Inc.300694Agent - Health9/4/200712/31/2007
ActiveAetna Health Inc. (PA)660717Agent - Health12/31/2007 
ActiveAetna Health of Ohio Inc.1065035Agent - Health8/6/2020 
ActiveAetna Life Insurance Company301140Agent - Health9/4/2007 
ActiveAetna Life Insurance Company301140Agent - Life9/4/2007 
ActiveAmerican General Life Insurance Company301585Agent - Health3/15/2011 
ActiveAmerican General Life Insurance Company301585Agent - Life3/15/2011 
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health11/30/2009 
ActiveAnthem Insurance Companies, Inc.300941Agent - Health10/22/2025 
InactiveAnthem Life Insurance Company301209Agent - Health11/30/20094/15/2025
InactiveAnthem Life Insurance Company301209Agent - Life11/30/20094/15/2025
InactiveAssurity Life Insurance Company301099Agent - Health3/4/201112/20/2018
InactiveAssurity Life Insurance Company301099Agent - Life3/4/201112/20/2018
InactiveAthene Annuity & Life Assurance Company301798Agent - Life9/5/20073/1/2011
ActiveAutomobile Insurance Company of Hartford, Connecticut300630Agent - Casualty1/20/2026 
ActiveAutomobile Insurance Company of Hartford, Connecticut300630Agent - Property1/20/2026 
InactiveBanner Life Insurance Company301696Agent - Life5/16/20133/14/2025
ActiveCIGNA Health & Life Insurance Company301783Agent - Health8/3/2018 
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health3/23/2025 
InactiveChesapeake Life Insurance Company (The)301017Agent - Health7/26/20122/3/2025
InactiveChesapeake Life Insurance Company (The)301017Agent - Life7/26/20122/3/2025
InactiveCompBenefits Dental, Inc.591692Agent - Health6/8/20093/14/2019
InactiveCompBenefits Insurance Company301864Agent - Health6/23/20097/2/2013
InactiveCompBenefits Insurance Company301864Agent - Life6/23/20097/2/2013
ActiveCompcare Health Services Insurance Corporation948751Agent - Health10/22/2025 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health3/6/2018 
ActiveDental Concern Inc. (The)301641Agent - Health3/21/2009 
InactiveFederal Insurance Company301144Agent - Health6/20/201912/29/2021
ActiveGolden Rule Insurance Company301943Agent - Health3/14/2007 
ActiveGolden Rule Insurance Company301943Agent - Life3/14/2007 
InactiveHCC Life Insurance Company301827Agent - Health11/3/20166/12/2017
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health7/10/20132/23/2018
ActiveHumana Health Plan, Inc.300142Agent - Health1/30/2008 
ActiveHumana Insurance Company301104Agent - Health1/30/2008 
ActiveHumana Insurance Company301104Agent - Life1/30/2008 
ActiveHumana Insurance Company of Kentucky300826Agent - Health1/30/2008 
ActiveHumana Insurance Company of Kentucky300826Agent - Life1/30/2008 
InactiveHumanaDental Insurance Company301457Agent - Health1/30/20082/23/2012
InactiveHumanaDental Insurance Company301457Agent - Life1/30/20082/23/2012
InactiveKanawha Insurance Company300127Agent - Health4/11/200810/22/2015
InactiveKanawha Insurance Company300127Agent - Life4/11/200810/22/2015
ActiveMarkel American Insurance Company300377Agent - Casualty7/28/2025 
ActiveMarkel American Insurance Company300377Agent - Property7/28/2025 
ActiveNational Health Insurance Company300554Agent - Health12/14/2024 
ActiveNational Health Insurance Company300554Agent - Life12/14/2024 
ActiveNationwide Mutual Insurance Company301749Agent - Casualty6/5/2026 
ActiveNationwide Mutual Insurance Company301749Agent - Property6/5/2026 
InactiveSecurity Life Insurance Company of America300936Agent - Health8/2/20073/24/2009
InactiveSecurity Life Insurance Company of America300936Agent - Life8/2/20073/24/2009
ActiveSilverScript Insurance Company663526Agent - Health1/2/2020 
ActiveSouthern Financial Life Insurance Company300664Agent - Health5/24/2013 
ActiveSouthern Financial Life Insurance Company300664Agent - Life5/24/2013 
ActiveStandard Fire Insurance Company (The)301068Agent - Casualty1/20/2026 
ActiveStandard Fire Insurance Company (The)301068Agent - Property1/20/2026 
ActiveStandard Insurance Company300185Agent - Health1/3/2025 
ActiveStandard Insurance Company300185Agent - Life1/3/2025 
InactiveStandard Security Life Insurance Company of NY301487Agent - Health4/10/201712/27/2018
InactiveStandard Security Life Insurance Company of NY301487Agent - Life4/10/201712/27/2018
InactiveStarr Indemnity and Liability Company301685Agent - Health4/16/20128/16/2018
ActiveThe Phoenix Insurance Company301502Agent - Casualty1/20/2026 
ActiveThe Phoenix Insurance Company301502Agent - Property1/20/2026 
InactiveTime Insurance Company300683Agent - Health3/11/200711/15/2019
InactiveTime Insurance Company300683Agent - Life3/11/200711/15/2019
ActiveTravelers Home and Marine Insurance Company (The)301802Agent - Casualty1/20/2026 
ActiveTravelers Home and Marine Insurance Company (The)301802Agent - Property1/20/2026 
InactiveUnified Life Insurance Company543169Agent - Health8/10/20154/6/2018
ActiveUnited States Fire Insurance Company582240Agent - Health4/4/2018 
ActiveUnitedHealthcare Insurance Company300946Agent - Health3/23/2025 
ActiveUnitedHealthcare Insurance Company300946Agent - Life4/21/2008 
InactiveUnitedHealthcare Insurance Company of America301552Agent - Health9/16/201612/20/2018
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health8/5/201912/22/2022
InactiveUnitedHealthcare Life Insurance Company301517Agent - Health11/11/201511/4/2016
InactiveUnitedHealthcare Life Insurance Company301517Agent - Life11/11/201511/4/2016
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health7/15/201812/23/2021
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health4/21/200811/29/2016
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health3/23/2025 
ActiveWellCare Health Insurance Company of Kentucky, Inc.301478Agent - Health9/24/2025 
ActiveWellCare Prescription Insurance Inc.654329Agent - Health9/24/2025 
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveKlemin, John R 812275Agent - Health12/3/201312/10/2024
InactiveKlemin, John R 812275Agent - Life12/3/201312/10/2024
InactiveKobbe, Eric Scot 603781Agent - Casualty8/14/202412/10/2024
InactiveKobbe, Eric Scot 603781Agent - Property8/14/202412/10/2024
InactiveNichols, Shane Reed 639287Agent - Health10/20/201212/31/2014
InactiveNichols, Shane Reed 639287Agent - Life3/5/200712/31/2014
ActiveWestlund, Brenda 1282429Agent - Casualty2/7/2025 
ActiveWestlund, Brenda 1282429Agent - Health12/4/2024 
ActiveWestlund, Brenda 1282429Agent - Life12/4/2024 
ActiveWestlund, Brenda 1282429Agent - Property2/7/2025 
ActiveWestlund, Brenda 1282429Surplus Lines Broker - Not Applicable7/25/2025 

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