DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burgess, Robin Marie	DOIID	651690	NAIC NPN	9132584

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Homestate	Administrator	Not Applicable	12/18/2009	9/30/2010
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anthem Health Plans of Kentucky (TPA)	401292	Administrator - Not Applicable	3/8/2010	9/30/2010
Inactive	Anthem Insurance Companies Inc. (TPA)	396067	Administrator - Not Applicable	3/8/2010	9/30/2010
Inactive	Claim Management Services, Inc.	602270	Administrator - Not Applicable	3/8/2010	9/30/2010
Inactive	Community Insurance Company (TPA)	395826	Administrator - Not Applicable	3/8/2010	9/30/2010
Inactive	RightCHOICE Managed Care, Inc	675266	Administrator - Not Applicable	3/17/2010	9/30/2010