DEPARTMENT OF INSURANCE

Affiliations

Name	Ellis, Jeff L	DOIID	665071	NAIC NPN	9713723

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	7/28/2014	5/1/2022
Inactive	Resident	Agent	Life	7/28/2014	5/1/2022
* 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
Inactive	American General Life Insurance Company	301585	Agent - Health	5/24/2008	10/20/2011
Inactive	American General Life Insurance Company	301585	Agent - Life	5/24/2008	10/20/2011
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021	5/1/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/25/2014	5/1/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/25/2014	5/1/2022
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	4/1/2011	4/30/2014
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	4/1/2011	4/30/2014
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/27/2014	4/13/2015
Inactive	CompBenefits Insurance Company	301864	Agent - Health	8/20/2008	7/2/2013
Inactive	CompBenefits Insurance Company	301864	Agent - Life	8/20/2008	7/2/2013
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/25/2021	5/1/2022
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	8/19/2008	4/30/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/27/2014	4/13/2015
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	5/20/2009	4/30/2014
Inactive	Forethought Life Insurance Company	301407	Agent - Health	5/4/2011	4/30/2014
Inactive	Forethought Life Insurance Company	301407	Agent - Life	5/4/2011	4/30/2014
Inactive	Genworth Life Insurance Company	300623	Agent - Health	6/3/2011	1/7/2014
Inactive	Genworth Life Insurance Company	300623	Agent - Life	6/3/2011	1/7/2014
Inactive	Gerber Life Insurance Company	300529	Agent - Health	4/8/2010	6/29/2012
Inactive	Gerber Life Insurance Company	300529	Agent - Life	4/8/2010	6/29/2012
Inactive	Golden Rule Insurance Company	301943	Agent - Health	5/1/2008	4/30/2014
Inactive	Golden Rule Insurance Company	301943	Agent - Life	5/1/2008	4/30/2014
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/27/2014	4/13/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/27/2014	4/13/2015
Inactive	Humana Insurance Company	301104	Agent - Health	9/27/2014	4/13/2015
Inactive	Humana Insurance Company	301104	Agent - Life	9/27/2014	4/13/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/27/2014	4/13/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/27/2014	4/13/2015
Inactive	HumanaDental Insurance Company	301457	Agent - Health	3/30/2012	5/13/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Life	3/30/2012	5/13/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/27/2014	4/13/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/27/2014	4/13/2015
Inactive	LifeSecure Insurance Company	301629	Agent - Health	7/1/2008	2/16/2010
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	6/8/2009	8/13/2012
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	6/8/2009	8/13/2012
Inactive	Marquette National Life Insurance Company	300117	Agent - Health	11/15/2008	9/13/2012
Inactive	Marquette National Life Insurance Company	300117	Agent - Life	11/15/2008	9/13/2012
Inactive	Medico Corp Life Insurance Company	301777	Agent - Health	7/16/2008	11/7/2008
Inactive	Medico Corp Life Insurance Company	301777	Agent - Life	7/16/2008	11/7/2008
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/7/2009	12/26/2012
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Health	11/15/2008	12/13/2012
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Life	11/15/2008	12/13/2012
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Health	11/15/2008	9/13/2012
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Life	11/15/2008	9/13/2012
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	4/21/2010	11/4/2011
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Health	11/15/2008	3/31/2013
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Life	11/15/2008	3/31/2013
Inactive	SILAC Insurance Company	300535	Agent - Health	6/30/2009	1/7/2010
Inactive	SILAC Insurance Company	300535	Agent - Life	6/30/2009	1/7/2010
Inactive	Symetra Life Insurance Company	301691	Agent - Health	4/1/2011	3/21/2012
Inactive	Symetra Life Insurance Company	301691	Agent - Life	4/1/2011	3/21/2012
Inactive	Time Insurance Company	300683	Agent - Health	6/23/2010	1/19/2012
Inactive	Time Insurance Company	300683	Agent - Life	6/23/2010	1/19/2012
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	7/27/2010	11/8/2010
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	7/27/2010	11/8/2010
Inactive	United American Insurance Company	300910	Agent - Health	10/12/2007	7/23/2008
Inactive	United American Insurance Company	300910	Agent - Life	10/12/2007	7/23/2008
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	5/7/2009	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	5/7/2009	12/26/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/17/2012	4/14/2014
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	6/12/2008	12/15/2009
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	6/12/2008	12/15/2009
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	9/17/2012	4/14/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	9/25/2014	5/1/2022
Inactive	Designated Agent Company Inc.	681257	Agent - Health	9/25/2014	5/1/2022
Inactive	Medlink Inc	400721	Agent - Life	8/17/2009	4/30/2014
Inactive	Medlink Inc	400721	Agent - Health	8/17/2009	4/30/2014
Inactive	Synergy Insurance Agency, Inc.	694265	Agent - Life	11/21/2008	3/31/2014
Inactive	Synergy Insurance Agency, Inc.	694265	Agent - Health	11/21/2008	3/31/2014