DEPARTMENT OF INSURANCE

Affiliations

Name	CBC Benefit & Insurance Services DBA : Custom Benefits Consultants, Inc	DOIID	700642	NAIC NPN	1907991

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	4/15/2009	3/31/2027
Active	Non Resident	Agent	Life	4/15/2009	3/31/2027
* 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	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	11/19/2018
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	5/3/2018
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/24/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	11/19/2018
Active	Aetna Life Insurance Company	301140	Agent - Life	11/19/2018
Active	All Savers Insurance Company	301940	Agent - Health	6/30/2023
Active	All Savers Insurance Company	301940	Agent - Life	6/30/2023
Inactive	American Continental Insurance Company	643130	Agent - Life	5/3/2018	8/11/2021
Active	Ameritas Life Insurance Corporation	300126	Agent - Health	1/5/2026
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/3/2012
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	1/3/2012	10/16/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/3/2012	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/3/2012	4/15/2025
Active	BCS Insurance Company	300294	Agent - Health	9/14/2023
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	10/5/2015
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022	3/3/2025
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	1/21/2014	12/13/2016
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	5/3/2018
Active	Dental Concern Inc. (The)	301641	Agent - Health	11/8/2024
Active	Dentegra Insurance Company	300462	Agent - Health	2/28/2017
Active	First Health Life & Health Insurance Company	301735	Agent - Health	11/19/2018
Inactive	Golden Rule Insurance Company	301943	Agent - Health	8/17/2016	1/20/2018
Inactive	Golden Rule Insurance Company	301943	Agent - Life	8/17/2016	1/20/2018
Inactive	HM Life Insurance Company	301408	Agent - Health	5/3/2016	5/31/2019
Inactive	HM Life Insurance Company	301408	Agent - Life	5/3/2016	5/31/2019
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	5/25/2017	12/19/2019
Inactive	Humana Insurance Company	301104	Agent - Health	5/8/2013	8/30/2013
Inactive	Humana Insurance Company	301104	Agent - Life	5/8/2013	8/30/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/8/2013	8/30/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	5/8/2013	8/30/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Health	3/29/2010	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	3/29/2010	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/29/2010	7/20/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/29/2010	7/20/2012
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	1/16/2018	3/15/2019
Active	NGL Insurance Company	300596	Agent - Health	5/21/2021
Active	Nationwide Life Insurance Company	300495	Agent - Health	5/21/2021
Active	Nationwide Life Insurance Company	300495	Agent - Life	5/21/2021
Inactive	Omaha Insurance Company	751908	Agent - Health	1/16/2018	3/15/2019
Active	SilverScript Insurance Company	663526	Agent - Health	10/19/2019
Inactive	Time Insurance Company	300683	Agent - Health	11/22/2014	11/15/2019
Inactive	Time Insurance Company	300683	Agent - Life	11/22/2014	11/15/2019
Active	United States Fire Insurance Company	582240	Agent - Health	11/12/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	1/16/2018	3/15/2019
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	1/16/2018	3/15/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/8/2016	3/3/2025
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	3/8/2016
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	8/30/2018	12/20/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/5/2019	12/22/2022
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	2/2/2026
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	6/1/2023	12/17/2024
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	8/30/2018	3/3/2025
Active	Vision Service Plan Insurance Company	300526	Agent - Health	9/12/2016
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	8/25/2023	2/28/2025
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	8/25/2023	2/28/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Bahl, Kenneth W	696629	Agent - Health	4/15/2009
Active	Bahl, Kenneth W	696629	Agent - Life	4/15/2009
Active	Czaplicki, Tamara	1272470	Agent - Health	5/21/2025
Denied	Czaplicki, Tamara	1272470	Agent - Life
Active	Moxley, Tawnia Marie	859040	Agent - Health	5/21/2025
Active	Moxley, Tawnia Marie	859040	Agent - Life	5/21/2025