DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Stacy, Kyle Branden	DOIID	651573	NAIC NPN	9132225

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	5/7/2007		10/31/2025
Active	Resident	Agent	Health	5/7/2007		10/31/2025
Active	Resident	Life & Health Consultant	Not Applicable	5/6/2013		10/31/2025
* 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
Active	Anthem Life Insurance Company	301209	Agent - Health	4/18/2011
Active	Anthem Life Insurance Company	301209	Agent - Life	4/18/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Benefit Ins Marketing Inc	398449	Agent - Health	4/18/2011
Active	Benefit Ins Marketing Inc	398449	Agent - Life	4/18/2011
Active	Designated Agent Company Inc.	681257	Agent - Health	12/11/2013
Active	Designated Agent Company Inc.	681257	Agent - Life	12/11/2013