DEPARTMENT OF INSURANCE

Affiliations

Name	Empyrean Insurance Services, Inc.	DOIID	662906	NAIC NPN	9417833

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	1/15/2019		3/31/2027
Active	Non Resident	Agent	Casualty	1/15/2019		3/31/2027
Inactive	Non Resident	Agent	Health	8/30/2007	2/12/2019
Inactive	Non Resident	Agent	Life	8/30/2007	2/12/2019
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	5/6/2008	2/12/2019
Inactive	Aetna Life Insurance Company	301140	Agent - Health	5/6/2008	2/12/2019
Inactive	Aetna Life Insurance Company	301140	Agent - Life	5/6/2008	2/12/2019
Inactive	American General Assurance Company	300586	Agent - Health	9/20/2009	7/25/2011
Inactive	American General Assurance Company	300586	Agent - Life	9/20/2009	7/25/2011
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/10/2007	11/3/2016
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	10/10/2007	10/16/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/10/2007	11/3/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/10/2007	11/3/2016
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	11/10/2015	12/13/2016
Inactive	CompBenefits Insurance Company	301864	Agent - Health	4/14/2008	6/26/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	4/14/2008	6/26/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	9/3/2013
Inactive	Golden Rule Insurance Company	301943	Agent - Health	8/8/2008	3/11/2010
Inactive	Golden Rule Insurance Company	301943	Agent - Life	8/8/2008	3/11/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/14/2008	9/3/2013
Inactive	Humana Insurance Company	301104	Agent - Health	4/14/2008	9/3/2013
Inactive	Humana Insurance Company	301104	Agent - Life	4/14/2008	9/3/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	7/22/2008	9/3/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	7/22/2008	9/3/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Health	7/22/2008	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	7/22/2008	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/30/2011	9/3/2013
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	4/18/2008	11/18/2010
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	4/18/2008	11/18/2010
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	5/27/2015	2/12/2019
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	5/27/2015	2/12/2019
Inactive	Time Insurance Company	300683	Agent - Health	4/21/2008	10/28/2011
Inactive	Time Insurance Company	300683	Agent - Life	4/21/2008	10/28/2011
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	5/27/2015	2/12/2019
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	5/27/2015	2/12/2019
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	9/20/2009	8/28/2012
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	9/20/2009	8/28/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	2/22/2008	12/1/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	2/22/2008	12/1/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	2/22/2008	12/1/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	2/22/2008	12/1/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Hernandez, Jill	1024111	Agent - Health
Denied	Hernandez, Jill	1024111	Agent - Life
Denied	Hooper, Savana Yarbro	677882	Agent - Health
Denied	Hooper, Savana Yarbro	677882	Agent - Life
Inactive	Mackey, Michael James	631048	Agent - Health	8/30/2007	4/30/2008
Inactive	Mackey, Michael James	631048	Agent - Life	8/30/2007	4/30/2008
Inactive	Perhala, Tiffaney Taylor	876311	Agent - Health	6/3/2015	2/12/2019
Inactive	Perhala, Tiffaney Taylor	876311	Agent - Life	6/3/2015	2/12/2019
Active	Priebe, James M	1024112	Agent - Casualty	1/15/2019
Denied	Priebe, James M	1024112	Agent - Health
Denied	Priebe, James M	1024112	Agent - Life
Active	Priebe, James M	1024112	Agent - Property	1/15/2019
Inactive	Sawyer, Andrew Todd	375873	Agent - Health	4/30/2008	9/13/2012
Inactive	Sawyer, Andrew Todd	375873	Agent - Life	4/30/2008	9/13/2012
Inactive	Taggart, Michael Harry	786974	Agent - Health	9/13/2012	8/27/2015
Inactive	Taggart, Michael Harry	786974	Agent - Life	9/13/2012	8/27/2015