DEPARTMENT OF INSURANCE
Affiliations
NameLongevity Alliance IncDOIID658429NAIC NPN9379248
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife6/27/2007 3/31/2027
ActiveNon ResidentAgentHealth6/27/2007 3/31/2027
InactiveNon ResidentAgentVariable Life and Variable Annuities6/27/20075/15/2019 
* 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
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202503/31/202501/16/202501/16/2025Yes
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAccendo Insurance Company300312Agent - Life6/10/2020 
InactiveAetna Health Inc.300694Agent - Health11/30/200712/31/2007
ActiveAetna Health Inc. (PA)660717Agent - Health12/31/2007 
ActiveAetna Health and Life Insurance Company300523Agent - Health12/10/2015 
ActiveAetna Health of Ohio Inc.1065035Agent - Health7/15/2020 
ActiveAetna Life Insurance Company301140Agent - Health11/30/2007 
ActiveAetna Life Insurance Company301140Agent - Life11/30/2007 
InactiveAmerican Continental Insurance Company643130Agent - Health12/14/200711/12/2014
InactiveAmerican Continental Insurance Company643130Agent - Life12/14/200711/12/2014
InactiveAmerican General Life Insurance Company301585Agent - Health4/18/200811/9/2012
InactiveAmerican General Life Insurance Company301585Agent - Life4/18/200811/9/2012
InactiveAmerican General Life Insurance Company301585Agent - Variable Life and Variable Annuities4/18/200811/9/2012
InactiveAmerican Retirement Life Insurance Company706303Agent - Health9/23/201312/18/2014
InactiveAmerican Retirement Life Insurance Company706303Agent - Life9/23/201312/18/2014
ActiveBanner Life Insurance Company301696Agent - Life6/25/2009 
ActiveCIGNA Health & Life Insurance Company301783Agent - Health3/4/2014 
InactiveCincinnati Life Insurance Company (The)300601Agent - Health2/25/201510/2/2019
InactiveCincinnati Life Insurance Company (The)300601Agent - Life2/25/201510/2/2019
InactiveCompBenefits Dental, Inc.591692Agent - Health4/13/201212/5/2014
InactiveConnecticut General Life Insurance Company301333Agent - Health10/2/20086/11/2014
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health12/14/2007 
InactiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Life12/14/20075/20/2016
InactiveDental Concern Inc. (The)301641Agent - Health8/25/201112/5/2014
ActiveFirst Health Life & Health Insurance Company301735Agent - Health12/4/2009 
InactiveGateway Health Plan of Ohio, Inc.833424Agent - Health11/18/20171/1/2019
InactiveGenworth Life Insurance Company300623Agent - Health4/7/200812/3/2019
InactiveGenworth Life Insurance Company300623Agent - Life4/7/200812/3/2019
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health9/28/200912/14/2016
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life9/28/200912/14/2016
InactiveGerber Life Insurance Company300529Agent - Health4/23/20101/27/2014
InactiveGerber Life Insurance Company300529Agent - Life4/23/20101/27/2014
InactiveGolden Rule Insurance Company301943Agent - Health2/5/200812/10/2014
InactiveGolden Rule Insurance Company301943Agent - Life2/5/200812/10/2014
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health11/15/20125/4/2015
InactiveHumana Health Plan, Inc.300142Agent - Health7/19/201012/5/2014
InactiveHumana Insurance Company301104Agent - Health7/19/20105/4/2015
InactiveHumana Insurance Company301104Agent - Life7/19/20105/4/2015
InactiveHumana Insurance Company of Kentucky300826Agent - Health7/19/201012/5/2014
InactiveHumana Insurance Company of Kentucky300826Agent - Life7/19/201012/5/2014
InactiveJackson National Life Insurance Company300486Agent - Life11/7/20137/2/2014
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities11/7/20137/2/2014
InactiveKanawha Insurance Company300127Agent - Health7/8/201312/5/2014
InactiveKanawha Insurance Company300127Agent - Life7/8/201312/5/2014
InactiveLincoln Benefit Life Company301110Agent - Health3/11/20087/14/2014
InactiveLincoln Benefit Life Company301110Agent - Life3/11/20087/14/2014
InactiveLincoln Benefit Life Company301110Agent - Variable Life and Variable Annuities3/11/20087/14/2014
InactiveMutual of Omaha Insurance Company301012Agent - Health3/7/20091/27/2014
InactiveNassau Life Insurance Company of Kansas300667Agent - Health11/15/20085/26/2011
InactiveOmaha Insurance Company751908Agent - Health4/23/20121/27/2014
InactivePacifiCare Life and Health Insurance Company301304Agent - Health4/24/200911/3/2011
InactivePacifiCare Life and Health Insurance Company301304Agent - Life4/24/20097/17/2012
InactivePennsylvania Life Insurance Company301321Agent - Health11/15/20085/26/2011
InactivePruco Life Insurance Company300954Agent - Health11/7/200812/24/2018
InactivePruco Life Insurance Company300954Agent - Life11/7/200812/24/2018
InactivePuritan Life Insurance Company of America301892Agent - Health1/9/20187/12/2019
InactivePuritan Life Insurance Company of America301892Agent - Life1/9/20187/12/2019
InactiveSecurity Life Insurance Company of America300936Agent - Health11/19/20089/14/2009
InactiveSecurity Life Insurance Company of America300936Agent - Life11/19/20089/14/2009
ActiveSilverScript Insurance Company663526Agent - Health10/8/2019 
InactiveSymetra Life Insurance Company301691Agent - Health11/11/20083/19/2010
InactiveSymetra Life Insurance Company301691Agent - Life11/11/20083/19/2010
ActiveTransamerica Life Insurance Company300571Agent - Health9/18/2008 
ActiveTransamerica Life Insurance Company300571Agent - Life9/18/2008 
InactiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities9/18/20085/15/2019
InactiveUnited World Life Insurance Company300532Agent - Health3/7/200912/15/2010
InactiveUnited of Omaha Life Insurance Company300156Agent - Health3/7/20091/27/2014
InactiveUnited of Omaha Life Insurance Company300156Agent - Life3/7/20091/27/2014
InactiveUnitedHealthcare Insurance Company300946Agent - Health4/24/200912/23/2019
InactiveUnitedHealthcare Insurance Company300946Agent - Life4/24/20096/7/2021
InactiveUnitedHealthcare Insurance Company of America301552Agent - Health9/11/201612/20/2018
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health7/31/201912/23/2019
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health7/15/201812/23/2019
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health8/2/201112/5/2016
InactiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health9/10/201512/23/2019
InactiveWellCare Health Insurance Company of Kentucky, Inc.301478Agent - Health12/17/201912/29/2021
InactiveWellCare Prescription Insurance Inc.654329Agent - Health12/20/201812/29/2021
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
DeniedBader, Joanne Cathy 757179Agent - Life  
InactiveBaldwin, Aaron Robert 703619Agent - Health10/8/200911/30/2011
InactiveBaldwin, Aaron Robert 703619Agent - Life10/8/200911/30/2011
InactiveBeasley, Vaughn Joseph 723810Agent - Health5/14/201011/30/2011
InactiveBeasley, Vaughn Joseph 723810Agent - Life5/14/201011/30/2011
InactiveBrown, Tiffany Lynn 945701Agent - Health5/3/20175/3/2017
InactiveBrown, Tiffany Lynn 945701Agent - Life5/3/20173/30/2018
InactiveByers, Deborah Ann 969709Agent - Health10/23/20171/23/2019
InactiveByers, Deborah Ann 969709Agent - Life10/23/20171/23/2019
InactiveCarter, Martha Lee 309306Agent - Health10/8/20095/14/2010
InactiveCarter, Martha Lee 309306Agent - Life10/8/20095/14/2010
InactiveCassens, Bruce Keane 545973Agent - Health6/27/20075/15/2019
InactiveCassens, Bruce Keane 545973Agent - Life6/27/20075/15/2019
InactiveCassens, Bruce Keane 545973Agent - Variable Life and Variable Annuities2/12/20095/15/2019
InactiveChavez, Emma 751264Agent - Health11/30/20118/31/2012
InactiveChavez, Emma 751264Agent - Life11/30/20118/31/2012
InactiveCook, David Orrin 711815Agent - Health10/8/20092/28/2014
InactiveCook, David Orrin 711815Agent - Life10/8/200912/26/2012
InactiveDilema, Howard Pestano 679192Agent - Health10/8/200911/30/2011
InactiveDilema, Howard Pestano 679192Agent - Life10/8/200911/30/2011
InactiveDreyer, Thomas Merriam 672674Agent - Health10/8/20093/30/2018
InactiveDreyer, Thomas Merriam 672674Agent - Life5/14/20103/30/2018
InactiveDvorak, Christine Elizabeth 616996Agent - Health11/30/20115/7/2015
InactiveDvorak, Christine Elizabeth 616996Agent - Life11/30/20115/7/2015
InactiveElijah, Dennis Robert 653871Agent - Health10/8/20098/27/2015
InactiveElijah, Dennis Robert 653871Agent - Life10/8/20098/27/2015
ActiveEmerton, David L 319947Agent - Health5/15/2019 
ActiveEmerton, David L 319947Agent - Life5/15/2019 
InactiveGarcia, Gustavo 816791Agent - Health8/6/201510/21/2016
InactiveGaughan, Charles Wilbur 687290Agent - Health10/8/200911/30/2011
InactiveGaughan, Charles Wilbur 687290Agent - Life10/8/200911/30/2011
InactiveHammett, Michael Shane 726242Agent - Health5/14/201011/30/2011
InactiveHammett, Michael Shane 726242Agent - Life5/14/201011/30/2011
InactiveHarraway, Virgil Darcy 544361Agent - Health5/14/20106/30/2011
InactiveHarraway, Virgil Darcy 544361Agent - Life5/14/20106/30/2011
InactiveKaminski, Cathleena Delores 763176Agent - Health11/30/20111/31/2014
InactiveKaminski, Cathleena Delores 763176Agent - Life11/30/20111/31/2014
InactiveKishpaugh, Evan James 740499Agent - Health11/30/20116/30/2013
InactiveKishpaugh, Evan James 740499Agent - Life11/30/20116/30/2013
InactiveLasswell, Diane Elizabeth 698059Agent - Health10/8/20098/31/2013
InactiveLasswell, Diane Elizabeth 698059Agent - Life10/8/20098/31/2013
InactiveLindgren, Mary Jean 705815Agent - Health10/8/20097/31/2013
InactiveLindgren, Mary Jean 705815Agent - Life10/8/20097/24/2013
InactiveMonk, Matthew Randall 765691Agent - Health11/30/20115/31/2014
InactiveMonk, Matthew Randall 765691Agent - Life11/30/20115/31/2014
DeniedNanayakkara, Amith C 601338Agent - Health  
DeniedNanayakkara, Amith C 601338Agent - Life  
InactiveOneal, Ruth Maite 763137Agent - Health6/30/201512/16/2016
InactiveOneal, Ruth Maite 763137Agent - Life6/30/201512/16/2016
InactivePlacencio, David Gomez 726237Agent - Health6/30/201512/16/2016
InactivePlacencio, David Gomez 726237Agent - Life6/30/201512/16/2016
InactivePoulsen, Royce E 718750Agent - Health5/14/20105/7/2015
InactivePoulsen, Royce E 718750Agent - Life5/14/20105/7/2015
InactiveRam, Jose Alfredo 714800Agent - Health9/21/20151/23/2019
InactiveRam, Jose Alfredo 714800Agent - Life9/21/20151/23/2019
InactiveRegalado, Ana 688610Agent - Health10/8/20099/30/2012
InactiveRegalado, Ana 688610Agent - Life10/8/20099/30/2012
InactiveRyan, Robyn Ann 692866Agent - Health10/8/20095/14/2010
InactiveRyan, Robyn Ann 692866Agent - Life10/8/20095/14/2010
InactiveSlavin, Susan 688646Agent - Health10/8/200910/31/2012
InactiveSmith, Leonard Stanley 506699Agent - Health6/27/200711/30/2008
InactiveSmith, Leonard Stanley 506699Agent - Life6/27/200711/30/2008
InactiveSmith, Leonard Stanley 506699Agent - Variable Life and Variable Annuities6/27/200711/30/2008
InactiveThayer, Mark Andrew 336216Agent - Health5/14/20109/30/2013
InactiveThayer, Mark Andrew 336216Agent - Life5/14/20109/30/2013
InactiveTyre, Matthew Elbert 759789Agent - Health11/30/20115/21/2015
InactiveTyre, Matthew Elbert 759789Agent - Life11/30/20115/21/2015
InactiveWestbrook, Janalee M 689246Agent - Health10/8/200911/30/2011
InactiveWright, Julie Ann 540136Agent - Health11/30/20113/31/2014
InactiveWright, Julie Ann 540136Agent - Life11/30/20113/31/2014
InactiveZeurcher, Maureen Ann 684985Agent - Health10/8/20095/14/2010
InactiveZeurcher, Maureen Ann 684985Agent - Life10/8/20095/14/2010

© Commonwealth of Kentucky. All rights reserved.