DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Moore, Samantha	DOIID	687951	NAIC NPN	10696689

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	8/27/2008		4/30/2027
Active	Non Resident	Agent	Health	8/27/2008		4/30/2027
* 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	02/15/2025	04/30/2025	03/20/2025	03/20/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	5/17/2013	10/12/2020
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	5/17/2013	10/12/2020
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	9/4/2008	6/14/2011
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	9/4/2008	6/14/2011
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	5/8/2019
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	5/8/2019
Active	Starmount Life Insurance Company	628031	Agent - Health	5/8/2019
Active	UNUM Life Insurance Company of America	300817	Agent - Health	5/8/2019
Active	UNUM Life Insurance Company of America	300817	Agent - Life	5/8/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/11/2011	12/1/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	7/11/2011	12/1/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/11/2011	12/1/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	7/11/2011	12/1/2016
Active	Unum Insurance Company	301499	Agent - Health	5/8/2019
Active	Unum Insurance Company	301499	Agent - Life	5/8/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Edgewood Partners Insurance Center	549891	Agent - Life	12/13/2017	3/8/2018
Inactive	Edgewood Partners Insurance Center	549891	Agent - Health	12/13/2017	3/8/2018
Active	Mercer Health & Benefits LLC	607080	Agent - Life	5/8/2019
Active	Mercer Health & Benefits LLC	607080	Agent - Health	5/8/2019
Active	Willis Towers Watson US LLC	705053	Agent - Life	7/28/2023
Active	Willis Towers Watson US LLC	705053	Agent - Health	7/28/2023