DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Catalyst360 LLC	DOIID	652333	NAIC NPN	9125053

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	3/28/2007		3/31/2027
* 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	ALPHA Dental Programs, Inc.	635438	Agent - Health	3/4/2020
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Active	Dentegra Insurance Company	300462	Agent - Health	5/3/2018
Inactive	Medico Insurance Company	301559	Agent - Health	1/29/2020	4/4/2022
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	2/6/2018
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	2/6/2018	12/20/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/5/2019	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	2/6/2018

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bergen, Jeffrey N	750096	Agent - Health	4/6/2011	6/7/2024
Inactive	Butterworth, Scott Alan	712807	Agent - Health	3/16/2011	4/6/2011
Active	Caruso, Michael John	617858	Agent - Health	10/3/2023
Inactive	Fleming, Walter Jay	533056	Agent - Health	3/28/2007	3/7/2011
Inactive	Kirkpatrick, Susan Amber	838220	Agent - Health	3/12/2018	2/15/2019
Active	Richie, Tara L	555695	Agent - Health	5/8/2023