DEPARTMENT OF INSURANCE

Affiliations

Name	Short, David A	DOIID	671275	NAIC NPN	3340413

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	1/3/2008	2/28/2027
Active	Non Resident	Agent	Life	1/3/2008	2/28/2027
* 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	12/15/2024	02/28/2025	01/28/2025	01/28/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American United Life Insurance Company	300498	Agent - Health	2/18/2024
Active	American United Life Insurance Company	300498	Agent - Life	2/18/2024
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/1/2023
Active	Anthem Life Insurance Company	301209	Agent - Health	8/1/2023
Active	Anthem Life Insurance Company	301209	Agent - Life	8/1/2023
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	5/10/2024
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/29/2013	3/14/2019
Pending Replacement	Dental Care Plus Inc.	301495	Agent - Health	4/26/2023
Active	Dental Concern Inc. (The)	301641	Agent - Health	2/21/2025
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	4/11/2023
Active	HCC Life Insurance Company	301827	Agent - Health	10/2/2024
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/30/2013	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/30/2013	12/19/2019
Active	Humana Insurance Company	301104	Agent - Health	2/21/2025
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	2/21/2025
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	2/21/2025
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/20/2014	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/20/2014	10/22/2015
Active	National Guardian Life Insurance Company	300596	Agent - Health	4/8/2022
Active	Nationwide Life Insurance Company	300495	Agent - Health	4/19/2022
Active	Nationwide Life Insurance Company	300495	Agent - Life	4/19/2022
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Health	8/15/2008	12/7/2018
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Life	8/15/2008	12/7/2018
Active	Pan-American Life Insurance Company	301530	Agent - Health	3/8/2023
Active	Pan-American Life Insurance Company	301530	Agent - Life	3/8/2023
Active	Reliance Standard Life Insurance Company	300584	Agent - Health	5/7/2024
Active	Reliance Standard Life Insurance Company	300584	Agent - Life	5/7/2024
Active	Sun Life Assurance Company of Canada	301811	Agent - Health	8/20/2024
Active	Sun Life Assurance Company of Canada	301811	Agent - Life	8/20/2024
Active	Trustmark Life Insurance Company	301286	Agent - Health	2/3/2023
Active	Trustmark Life Insurance Company	301286	Agent - Life	2/3/2023
Active	Western-Southern Life Assurance Company	301590	Agent - Health	10/19/2023
Active	Western-Southern Life Assurance Company	301590	Agent - Life	10/19/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Patriot Growth Insurance Services LLC	1002152	Agent - Life	9/22/2021
Active	Patriot Growth Insurance Services LLC	1002152	Agent - Health	9/22/2021