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DEPARTMENT OF INSURANCE
Affiliations
Name
Longevity Alliance Inc
DOIID
658429
NAIC NPN
9379248
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Active
Non Resident
Agent
Life
6/27/2007
3/31/2027
Active
Non Resident
Agent
Health
6/27/2007
3/31/2027
Inactive
Non Resident
Agent
Variable Life and Variable Annuities
6/27/2007
5/15/2019
* If a status Is
Pending, Pending Replacement
,Or the record displays
Affidavit On File
, click On them For more details.
Notice:
The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.
License Renewal Information
Class
Invoice Date
Response Due / Expiration Date
Response Received Date
Payment Received Date
Renewal Complete
Agent
01/15/2025
03/31/2025
01/16/2025
01/16/2025
Yes
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Active
Accendo Insurance Company
300312
Agent - Life
6/10/2020
Inactive
Aetna Health Inc.
300694
Agent - Health
11/30/2007
12/31/2007
Active
Aetna Health Inc. (PA)
660717
Agent - Health
12/31/2007
Active
Aetna Health and Life Insurance Company
300523
Agent - Health
12/10/2015
Active
Aetna Health of Ohio Inc.
1065035
Agent - Health
7/15/2020
Active
Aetna Life Insurance Company
301140
Agent - Health
11/30/2007
Active
Aetna Life Insurance Company
301140
Agent - Life
11/30/2007
Inactive
American Continental Insurance Company
643130
Agent - Health
12/14/2007
11/12/2014
Inactive
American Continental Insurance Company
643130
Agent - Life
12/14/2007
11/12/2014
Inactive
American General Life Insurance Company
301585
Agent - Health
4/18/2008
11/9/2012
Inactive
American General Life Insurance Company
301585
Agent - Life
4/18/2008
11/9/2012
Inactive
American General Life Insurance Company
301585
Agent - Variable Life and Variable Annuities
4/18/2008
11/9/2012
Inactive
American Retirement Life Insurance Company
706303
Agent - Health
9/23/2013
12/18/2014
Inactive
American Retirement Life Insurance Company
706303
Agent - Life
9/23/2013
12/18/2014
Active
Banner Life Insurance Company
301696
Agent - Life
6/25/2009
Active
CIGNA Health & Life Insurance Company
301783
Agent - Health
3/4/2014
Inactive
Cincinnati Life Insurance Company (The)
300601
Agent - Health
2/25/2015
10/2/2019
Inactive
Cincinnati Life Insurance Company (The)
300601
Agent - Life
2/25/2015
10/2/2019
Inactive
CompBenefits Dental, Inc.
591692
Agent - Health
4/13/2012
12/5/2014
Inactive
Connecticut General Life Insurance Company
301333
Agent - Health
10/2/2008
6/11/2014
Active
Continental Life Insurance Company of Brentwood Tennessee
301526
Agent - Health
12/14/2007
Inactive
Continental Life Insurance Company of Brentwood Tennessee
301526
Agent - Life
12/14/2007
5/20/2016
Inactive
Dental Concern Inc. (The)
301641
Agent - Health
8/25/2011
12/5/2014
Active
First Health Life & Health Insurance Company
301735
Agent - Health
12/4/2009
Inactive
Gateway Health Plan of Ohio, Inc.
833424
Agent - Health
11/18/2017
1/1/2019
Inactive
Genworth Life Insurance Company
300623
Agent - Health
4/7/2008
12/3/2019
Inactive
Genworth Life Insurance Company
300623
Agent - Life
4/7/2008
12/3/2019
Inactive
Genworth Life and Annuity Insurance Company
301276
Agent - Health
9/28/2009
12/14/2016
Inactive
Genworth Life and Annuity Insurance Company
301276
Agent - Life
9/28/2009
12/14/2016
Inactive
Gerber Life Insurance Company
300529
Agent - Health
4/23/2010
1/27/2014
Inactive
Gerber Life Insurance Company
300529
Agent - Life
4/23/2010
1/27/2014
Inactive
Golden Rule Insurance Company
301943
Agent - Health
2/5/2008
12/10/2014
Inactive
Golden Rule Insurance Company
301943
Agent - Life
2/5/2008
12/10/2014
Inactive
Humana Health Plan of Ohio Inc.
301565
Agent - Health
11/15/2012
5/4/2015
Inactive
Humana Health Plan, Inc.
300142
Agent - Health
7/19/2010
12/5/2014
Inactive
Humana Insurance Company
301104
Agent - Health
7/19/2010
5/4/2015
Inactive
Humana Insurance Company
301104
Agent - Life
7/19/2010
5/4/2015
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Health
7/19/2010
12/5/2014
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Life
7/19/2010
12/5/2014
Inactive
Jackson National Life Insurance Company
300486
Agent - Life
11/7/2013
7/2/2014
Inactive
Jackson National Life Insurance Company
300486
Agent - Variable Life and Variable Annuities
11/7/2013
7/2/2014
Inactive
Kanawha Insurance Company
300127
Agent - Health
7/8/2013
12/5/2014
Inactive
Kanawha Insurance Company
300127
Agent - Life
7/8/2013
12/5/2014
Inactive
Lincoln Benefit Life Company
301110
Agent - Health
3/11/2008
7/14/2014
Inactive
Lincoln Benefit Life Company
301110
Agent - Life
3/11/2008
7/14/2014
Inactive
Lincoln Benefit Life Company
301110
Agent - Variable Life and Variable Annuities
3/11/2008
7/14/2014
Inactive
Mutual of Omaha Insurance Company
301012
Agent - Health
3/7/2009
1/27/2014
Inactive
Nassau Life Insurance Company of Kansas
300667
Agent - Health
11/15/2008
5/26/2011
Inactive
Omaha Insurance Company
751908
Agent - Health
4/23/2012
1/27/2014
Inactive
PacifiCare Life and Health Insurance Company
301304
Agent - Health
4/24/2009
11/3/2011
Inactive
PacifiCare Life and Health Insurance Company
301304
Agent - Life
4/24/2009
7/17/2012
Inactive
Pennsylvania Life Insurance Company
301321
Agent - Health
11/15/2008
5/26/2011
Inactive
Pruco Life Insurance Company
300954
Agent - Health
11/7/2008
12/24/2018
Inactive
Pruco Life Insurance Company
300954
Agent - Life
11/7/2008
12/24/2018
Inactive
Puritan Life Insurance Company of America
301892
Agent - Health
1/9/2018
7/12/2019
Inactive
Puritan Life Insurance Company of America
301892
Agent - Life
1/9/2018
7/12/2019
Inactive
Security Life Insurance Company of America
300936
Agent - Health
11/19/2008
9/14/2009
Inactive
Security Life Insurance Company of America
300936
Agent - Life
11/19/2008
9/14/2009
Active
SilverScript Insurance Company
663526
Agent - Health
10/8/2019
Inactive
Symetra Life Insurance Company
301691
Agent - Health
11/11/2008
3/19/2010
Inactive
Symetra Life Insurance Company
301691
Agent - Life
11/11/2008
3/19/2010
Active
Transamerica Life Insurance Company
300571
Agent - Health
9/18/2008
Active
Transamerica Life Insurance Company
300571
Agent - Life
9/18/2008
Inactive
Transamerica Life Insurance Company
300571
Agent - Variable Life and Variable Annuities
9/18/2008
5/15/2019
Inactive
United World Life Insurance Company
300532
Agent - Health
3/7/2009
12/15/2010
Inactive
United of Omaha Life Insurance Company
300156
Agent - Health
3/7/2009
1/27/2014
Inactive
United of Omaha Life Insurance Company
300156
Agent - Life
3/7/2009
1/27/2014
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Health
4/24/2009
12/23/2019
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Life
4/24/2009
6/7/2021
Inactive
UnitedHealthcare Insurance Company of America
301552
Agent - Health
9/11/2016
12/20/2018
Inactive
UnitedHealthcare Insurance Company of the River Valley
1027817
Agent - Health
7/31/2019
12/23/2019
Inactive
UnitedHealthcare of Kentucky, Ltd.
301337
Agent - Health
7/15/2018
12/23/2019
Inactive
UnitedHealthcare of Ohio, Inc.
300493
Agent - Health
8/2/2011
12/5/2016
Inactive
UnitedHealthcare of Wisconsin, Inc.
871491
Agent - Health
9/10/2015
12/23/2019
Inactive
WellCare Health Insurance Company of Kentucky, Inc.
301478
Agent - Health
12/17/2019
12/29/2021
Inactive
WellCare Prescription Insurance Inc.
654329
Agent - Health
12/20/2018
12/29/2021
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Denied
Bader, Joanne Cathy
757179
Agent - Life
Inactive
Baldwin, Aaron Robert
703619
Agent - Health
10/8/2009
11/30/2011
Inactive
Baldwin, Aaron Robert
703619
Agent - Life
10/8/2009
11/30/2011
Inactive
Beasley, Vaughn Joseph
723810
Agent - Health
5/14/2010
11/30/2011
Inactive
Beasley, Vaughn Joseph
723810
Agent - Life
5/14/2010
11/30/2011
Inactive
Brown, Tiffany Lynn
945701
Agent - Health
5/3/2017
5/3/2017
Inactive
Brown, Tiffany Lynn
945701
Agent - Life
5/3/2017
3/30/2018
Inactive
Byers, Deborah Ann
969709
Agent - Health
10/23/2017
1/23/2019
Inactive
Byers, Deborah Ann
969709
Agent - Life
10/23/2017
1/23/2019
Inactive
Carter, Martha Lee
309306
Agent - Health
10/8/2009
5/14/2010
Inactive
Carter, Martha Lee
309306
Agent - Life
10/8/2009
5/14/2010
Inactive
Cassens, Bruce Keane
545973
Agent - Health
6/27/2007
5/15/2019
Inactive
Cassens, Bruce Keane
545973
Agent - Life
6/27/2007
5/15/2019
Inactive
Cassens, Bruce Keane
545973
Agent - Variable Life and Variable Annuities
2/12/2009
5/15/2019
Inactive
Chavez, Emma
751264
Agent - Health
11/30/2011
8/31/2012
Inactive
Chavez, Emma
751264
Agent - Life
11/30/2011
8/31/2012
Inactive
Cook, David Orrin
711815
Agent - Health
10/8/2009
2/28/2014
Inactive
Cook, David Orrin
711815
Agent - Life
10/8/2009
12/26/2012
Inactive
Dilema, Howard Pestano
679192
Agent - Health
10/8/2009
11/30/2011
Inactive
Dilema, Howard Pestano
679192
Agent - Life
10/8/2009
11/30/2011
Inactive
Dreyer, Thomas Merriam
672674
Agent - Health
10/8/2009
3/30/2018
Inactive
Dreyer, Thomas Merriam
672674
Agent - Life
5/14/2010
3/30/2018
Inactive
Dvorak, Christine Elizabeth
616996
Agent - Health
11/30/2011
5/7/2015
Inactive
Dvorak, Christine Elizabeth
616996
Agent - Life
11/30/2011
5/7/2015
Inactive
Elijah, Dennis Robert
653871
Agent - Health
10/8/2009
8/27/2015
Inactive
Elijah, Dennis Robert
653871
Agent - Life
10/8/2009
8/27/2015
Active
Emerton, David L
319947
Agent - Health
5/15/2019
Active
Emerton, David L
319947
Agent - Life
5/15/2019
Inactive
Garcia, Gustavo
816791
Agent - Health
8/6/2015
10/21/2016
Inactive
Gaughan, Charles Wilbur
687290
Agent - Health
10/8/2009
11/30/2011
Inactive
Gaughan, Charles Wilbur
687290
Agent - Life
10/8/2009
11/30/2011
Inactive
Hammett, Michael Shane
726242
Agent - Health
5/14/2010
11/30/2011
Inactive
Hammett, Michael Shane
726242
Agent - Life
5/14/2010
11/30/2011
Inactive
Harraway, Virgil Darcy
544361
Agent - Health
5/14/2010
6/30/2011
Inactive
Harraway, Virgil Darcy
544361
Agent - Life
5/14/2010
6/30/2011
Inactive
Kaminski, Cathleena Delores
763176
Agent - Health
11/30/2011
1/31/2014
Inactive
Kaminski, Cathleena Delores
763176
Agent - Life
11/30/2011
1/31/2014
Inactive
Kishpaugh, Evan James
740499
Agent - Health
11/30/2011
6/30/2013
Inactive
Kishpaugh, Evan James
740499
Agent - Life
11/30/2011
6/30/2013
Inactive
Lasswell, Diane Elizabeth
698059
Agent - Health
10/8/2009
8/31/2013
Inactive
Lasswell, Diane Elizabeth
698059
Agent - Life
10/8/2009
8/31/2013
Inactive
Lindgren, Mary Jean
705815
Agent - Health
10/8/2009
7/31/2013
Inactive
Lindgren, Mary Jean
705815
Agent - Life
10/8/2009
7/24/2013
Inactive
Monk, Matthew Randall
765691
Agent - Health
11/30/2011
5/31/2014
Inactive
Monk, Matthew Randall
765691
Agent - Life
11/30/2011
5/31/2014
Denied
Nanayakkara, Amith C
601338
Agent - Health
Denied
Nanayakkara, Amith C
601338
Agent - Life
Inactive
Oneal, Ruth Maite
763137
Agent - Health
6/30/2015
12/16/2016
Inactive
Oneal, Ruth Maite
763137
Agent - Life
6/30/2015
12/16/2016
Inactive
Placencio, David Gomez
726237
Agent - Health
6/30/2015
12/16/2016
Inactive
Placencio, David Gomez
726237
Agent - Life
6/30/2015
12/16/2016
Inactive
Poulsen, Royce E
718750
Agent - Health
5/14/2010
5/7/2015
Inactive
Poulsen, Royce E
718750
Agent - Life
5/14/2010
5/7/2015
Inactive
Ram, Jose Alfredo
714800
Agent - Health
9/21/2015
1/23/2019
Inactive
Ram, Jose Alfredo
714800
Agent - Life
9/21/2015
1/23/2019
Inactive
Regalado, Ana
688610
Agent - Health
10/8/2009
9/30/2012
Inactive
Regalado, Ana
688610
Agent - Life
10/8/2009
9/30/2012
Inactive
Ryan, Robyn Ann
692866
Agent - Health
10/8/2009
5/14/2010
Inactive
Ryan, Robyn Ann
692866
Agent - Life
10/8/2009
5/14/2010
Inactive
Slavin, Susan
688646
Agent - Health
10/8/2009
10/31/2012
Inactive
Smith, Leonard Stanley
506699
Agent - Health
6/27/2007
11/30/2008
Inactive
Smith, Leonard Stanley
506699
Agent - Life
6/27/2007
11/30/2008
Inactive
Smith, Leonard Stanley
506699
Agent - Variable Life and Variable Annuities
6/27/2007
11/30/2008
Inactive
Thayer, Mark Andrew
336216
Agent - Health
5/14/2010
9/30/2013
Inactive
Thayer, Mark Andrew
336216
Agent - Life
5/14/2010
9/30/2013
Inactive
Tyre, Matthew Elbert
759789
Agent - Health
11/30/2011
5/21/2015
Inactive
Tyre, Matthew Elbert
759789
Agent - Life
11/30/2011
5/21/2015
Inactive
Westbrook, Janalee M
689246
Agent - Health
10/8/2009
11/30/2011
Inactive
Wright, Julie Ann
540136
Agent - Health
11/30/2011
3/31/2014
Inactive
Wright, Julie Ann
540136
Agent - Life
11/30/2011
3/31/2014
Inactive
Zeurcher, Maureen Ann
684985
Agent - Health
10/8/2009
5/14/2010
Inactive
Zeurcher, Maureen Ann
684985
Agent - Life
10/8/2009
5/14/2010
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