DEPARTMENT OF INSURANCE

Affiliations

Name	Partners Benefit Group LLC	DOIID	675594	NAIC NPN	9207990

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	5/31/2022		3/31/2026
Inactive	Non Resident	Agent	Health	3/31/2008	9/1/2022
* 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	Accendo Insurance Company	300312	Agent - Life	6/10/2020	2/1/2022
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	5/15/2009	9/1/2022
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/10/2020	9/1/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	5/15/2009	9/1/2022
Active	Aetna Life Insurance Company	301140	Agent - Life	2/13/2024
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	5/1/2009	11/3/2016
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	5/1/2009	10/16/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	5/1/2009	11/3/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/1/2009	11/3/2016
Inactive	Banner Life Insurance Company	301696	Agent - Life	1/10/2013	2/1/2022
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	1/16/2020	9/1/2022
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	6/7/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018	9/1/2022
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	2/3/2012	4/15/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	2/3/2012	4/15/2015
Inactive	Humana Insurance Company	301104	Agent - Health	2/3/2012	4/15/2015
Inactive	Humana Insurance Company	301104	Agent - Life	2/3/2012	4/15/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/3/2012	4/15/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/3/2012	4/15/2015
Inactive	Nippon Life Insurance Company of America	300446	Agent - Health	7/15/2018	9/1/2022
Inactive	Nippon Life Insurance Company of America	300446	Agent - Life	7/15/2018	2/1/2022
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/9/2019	9/1/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bradley, Stacy Lynn	1135509	Agent - Health	2/15/2022	6/3/2022
Inactive	Simmons, Gary Marvin	594387	Agent - Health	3/31/2008	11/30/2021
Inactive	Simmons, Gary Marvin	594387	Agent - Life	3/31/2008	11/30/2021
Active	Stokes, Kimberly Dawn	1157629	Agent - Life	5/31/2022
Denied	Willis, Karen Stroud	1207934	Agent - Health
Inactive	Willis, Karen Stroud	1207934	Agent - Life	5/31/2022	4/11/2024