DEPARTMENT OF INSURANCE

Affiliations

Name	Willis Towers Watson US LLC	DOIID	705053	NAIC NPN	1633049

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	5/29/2009	3/31/2025
Active	Non Resident	Agent	Property	10/17/2013	3/31/2025
Active	Non Resident	Agent	Health	5/29/2009	3/31/2025
Active	Non Resident	Agent	Casualty	10/17/2013	3/31/2025
* 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	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	ACE American Insurance Company	300625	Agent - Health	1/7/2019
Active	ACE Property and Casualty Insurance Company	300520	Agent - Health	1/14/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	11/10/2009
Active	Aetna Life Insurance Company	301140	Agent - Health	11/10/2009
Active	Aetna Life Insurance Company	301140	Agent - Life	11/10/2009
Active	All Savers Insurance Company	301940	Agent - Health	7/1/2023
Active	All Savers Insurance Company	301940	Agent - Life	7/1/2023
Active	American Heritage Life Insurance Company	300272	Agent - Health	8/18/2017
Active	American Heritage Life Insurance Company	300272	Agent - Life	8/18/2017
Active	American Pet Insurance Company, Inc.	301240	Agent - Casualty	9/1/2023
Active	American Pet Insurance Company, Inc.	301240	Agent - Property	9/1/2023
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	7/23/2009
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	7/23/2009	10/16/2012
Active	Anthem Life Insurance Company	301209	Agent - Health	7/23/2009
Active	Anthem Life Insurance Company	301209	Agent - Life	7/23/2009
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	1/20/2015	12/21/2015
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	1/20/2015	12/21/2015
Active	CIGNA Dental Health of Kentucky, Inc.	300904	Agent - Health	2/4/2013
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	2/4/2013
Active	CIGNA Health & Life Insurance Company	301783	Agent - Life	2/4/2013
Active	Colonial Life and Accident Insurance Company	300846	Agent - Health	9/20/2018
Active	Colonial Life and Accident Insurance Company	300846	Agent - Life	9/20/2018
Active	Combined Insurance Company of America	301472	Agent - Health	6/9/2009
Active	Combined Insurance Company of America	301472	Agent - Life	6/9/2009
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	2/4/2013	9/26/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	2/4/2013	9/26/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	2/3/2015	12/8/2015
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	6/27/2022
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	6/27/2022
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	12/29/2014
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	12/29/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	2/3/2015	12/8/2015
Active	Humana Insurance Company	301104	Agent - Health	3/27/2024
Inactive	Humana Insurance Company	301104	Agent - Life	2/3/2015	12/8/2015
Active	Independence American Insurance Company	524747	Agent - Casualty	9/7/2023
Active	Independence American Insurance Company	524747	Agent - Property	9/8/2020
Active	Insurance Company of the State of Pennsylvania	300807	Agent - Casualty	7/28/2021
Active	Insurance Company of the State of Pennsylvania	300807	Agent - Property	7/28/2021
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/29/2015	12/8/2017
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/29/2015	12/8/2017
Active	Life Insurance Company of North America	300711	Agent - Health	12/20/2018
Active	Life Insurance Company of North America	300711	Agent - Life	12/20/2018
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Health	12/22/2015	10/29/2019
Inactive	Lincoln Life Assurance Company of Boston	301915	Agent - Life	12/22/2015	10/29/2019
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	8/22/2022
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	8/22/2022
Active	Metropolitan Life Insurance Company	301948	Agent - Health	6/2/2009
Active	Metropolitan Life Insurance Company	301948	Agent - Life	6/2/2009
Active	Minnesota Life Insurance Company	300488	Agent - Health	1/4/2021
Active	Minnesota Life Insurance Company	300488	Agent - Life	1/4/2021
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	7/28/2021
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	7/28/2021
Active	Nationwide Life Insurance Company	300495	Agent - Health	7/14/2009
Active	Nationwide Life Insurance Company	300495	Agent - Life	7/14/2009
Active	New Hampshire Insurance Company	301670	Agent - Casualty	7/28/2021
Active	New Hampshire Insurance Company	301670	Agent - Property	7/28/2021
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	6/3/2009
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	6/3/2009
Active	Prudential Insurance Company of America	300784	Agent - Health	10/14/2021
Active	Prudential Insurance Company of America	300784	Agent - Life	10/14/2021
Active	ReliaStar Life Insurance Company	301712	Agent - Health	10/10/2013
Active	ReliaStar Life Insurance Company	301712	Agent - Life	10/10/2013
Active	Reliance Standard Life Insurance Company	300584	Agent - Health	1/12/2017
Active	Securian Life Insurance Company	300757	Agent - Health	1/4/2021
Active	Securian Life Insurance Company	300757	Agent - Life	1/4/2021
Active	Standard Fire Insurance Company (The)	301068	Agent - Casualty	10/17/2017
Active	Standard Fire Insurance Company (The)	301068	Agent - Property	10/17/2017
Active	Starmount Life Insurance Company	628031	Agent - Health	11/18/2022
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	1/20/2015	12/21/2015
Inactive	The Phoenix Insurance Company	301502	Agent - Property	1/20/2015	12/21/2015
Active	Travelers Commercial Insurance Company	301506	Agent - Casualty	7/11/2017
Active	Travelers Commercial Insurance Company	301506	Agent - Property	7/11/2017
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	1/20/2015	12/21/2015
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	1/20/2015	12/21/2015
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	8/22/2017	12/9/2019
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	8/22/2017	12/9/2019
Active	Trustmark Insurance Company	300317	Agent - Health	8/6/2021
Active	Trustmark Insurance Company	300317	Agent - Life	8/6/2021
Active	UNUM Life Insurance Company of America	300817	Agent - Health	6/3/2009
Active	UNUM Life Insurance Company of America	300817	Agent - Life	6/3/2009
Active	United States Fire Insurance Company	582240	Agent - Casualty	2/4/2019
Active	United States Fire Insurance Company	582240	Agent - Property	2/4/2019
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	7/1/2023
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	7/1/2023
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/1/2023
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	7/1/2023
Active	Unum Insurance Company	301499	Agent - Health	11/18/2022
Active	Unum Insurance Company	301499	Agent - Life	11/18/2022
Active	Zurich American Insurance Company	301121	Agent - Casualty	3/5/2020
Active	Zurich American Insurance Company	301121	Agent - Property	3/5/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ageloff, Alexandra Novy	628750	Agent - Health	6/19/2023	1/10/2024
Inactive	Ageloff, Alexandra Novy	628750	Agent - Life	8/8/2023	1/10/2024
Denied	Arena, Stephen	1182896	Agent - Health
Denied	Arena, Stephen	1182896	Agent - Life
Active	Baarlaer, Clare Ann	857421	Agent - Health	6/28/2023
Active	Baarlaer, Clare Ann	857421	Agent - Life	6/28/2023
Active	Belko, Robert Walter	545127	Agent - Casualty	3/31/2023
Active	Belko, Robert Walter	545127	Agent - Health	6/28/2023
Active	Belko, Robert Walter	545127	Agent - Life	6/28/2023
Active	Belko, Robert Walter	545127	Agent - Property	10/17/2013
Active	Bookman, Eric	1341832	Agent - Health	6/13/2024
Active	Bookman, Eric	1341832	Agent - Life	6/13/2024
Active	Bukowski, Mark Stephen	692923	Agent - Health	6/21/2016
Active	Bukowski, Mark Stephen	692923	Agent - Life	6/21/2016
Active	Cantwell, Jonathan L	1300521	Agent - Health	10/31/2023
Active	Cantwell, Jonathan L	1300521	Agent - Life	10/31/2023
Active	Cocchia, Christine P	1322552	Agent - Health	4/15/2024
Active	Cocchia, Christine P	1322552	Agent - Life	4/15/2024
Active	Corning, Jessica Lynn	1274916	Agent - Health	6/28/2023
Active	Corning, Jessica Lynn	1274916	Agent - Life	7/12/2023
Active	Davidson, Nicole	818150	Agent - Health	6/28/2023
Active	Davidson, Nicole	818150	Agent - Life	6/28/2023
Active	De La Parra, Lydia	1276890	Agent - Health	12/16/2023
Active	De La Parra, Lydia	1276890	Agent - Life	12/20/2023
Active	Demetrius, Andre Barrington	743198	Agent - Health	6/21/2016
Active	Demetrius, Andre Barrington	743198	Agent - Life	6/21/2016
Inactive	Dowd, Jacquelyn R	584986	Agent - Health	5/29/2009	3/31/2023
Inactive	Dowd, Jacquelyn R	584986	Agent - Life	5/29/2009	3/31/2023
Active	Edusei, James	915406	Agent - Health	11/13/2023
Active	Edusei, James	915406	Agent - Life	11/13/2023
Inactive	Eicher, Robert Daniel	504496	Agent - Health	6/9/2015	1/24/2019
Inactive	Eicher, Robert Daniel	504496	Agent - Life	6/9/2015	1/24/2019
Active	Eichstadt, Adam Lee	768653	Agent - Health	2/4/2013
Active	Eichstadt, Adam Lee	768653	Agent - Life	2/4/2013
Active	Freedman, Marc Bradley	557594	Agent - Health	6/21/2016
Active	Freedman, Marc Bradley	557594	Agent - Life	6/21/2016
Active	Gantz, Robin Sue	732277	Agent - Life	6/28/2023
Active	Grellner, Elizabeth A	822833	Agent - Casualty	6/28/2023
Active	Grellner, Elizabeth A	822833	Agent - Health	6/21/2016
Active	Grellner, Elizabeth A	822833	Agent - Life	6/21/2016
Active	Grellner, Elizabeth A	822833	Agent - Property	6/28/2023
Active	Hamer, Marsha	735658	Agent - Casualty	4/15/2024
Active	Hamer, Marsha	735658	Agent - Health	4/15/2024
Active	Hamer, Marsha	735658	Agent - Life	4/15/2024
Active	Hamer, Marsha	735658	Agent - Property	4/15/2024
Inactive	Harten, Joseph Edward	693918	Agent - Health	8/4/2009	1/3/2013
Inactive	Harten, Joseph Edward	693918	Agent - Life	8/4/2009	1/3/2013
Active	Hebert, Mark Steven	555482	Agent - Casualty	2/4/2019
Denied	Hebert, Mark Steven	555482	Agent - Health
Denied	Hebert, Mark Steven	555482	Agent - Life
Active	Hebert, Mark Steven	555482	Agent - Property	2/4/2019
Active	Henry, Alexander Stephen	1274914	Agent - Health	6/28/2023
Active	Henry, Alexander Stephen	1274914	Agent - Life	7/1/2023
Active	Hoefinghoff, Tyler Richard	1014784	Agent - Health	6/28/2023
Active	Hoefinghoff, Tyler Richard	1014784	Agent - Life	7/13/2023
Active	Johnson, Julie Lynn	939662	Agent - Casualty	6/28/2023
Active	Johnson, Julie Lynn	939662	Agent - Health	6/28/2023
Active	Johnson, Julie Lynn	939662	Agent - Life	6/28/2023
Active	Johnson, Julie Lynn	939662	Agent - Property	6/28/2023
Active	Keller, Jensen	1146785	Agent - Health	11/21/2023
Active	Keller, Jensen	1146785	Agent - Life	11/21/2023
Active	Keller, Meghan	826377	Agent - Health	7/19/2023
Active	Keller, Meghan	826377	Agent - Life	7/19/2023
Active	Lawrence, Jennifer	811740	Agent - Health	6/28/2023
Active	Lawrence, Jennifer	811740	Agent - Life	6/28/2023
Denied	Lewis, Amber	816065	Agent - Casualty
Denied	Lewis, Amber	816065	Agent - Health
Denied	Lewis, Amber	816065	Agent - Life
Denied	Lewis, Amber	816065	Agent - Property
Active	Lewis, Diana Nicole	548409	Agent - Health	11/7/2023
Active	Lewis, Diana Nicole	548409	Agent - Life	11/7/2023
Active	Masony, Jason Michael	800583	Agent - Health	1/28/2013
Active	Masony, Jason Michael	800583	Agent - Life	1/28/2013
Active	Mccall, Jennifer L	1057869	Agent - Life	6/28/2023
Active	Moore, Samantha	687951	Agent - Health	7/28/2023
Active	Moore, Samantha	687951	Agent - Life	7/28/2023
Active	Moorman, Deborah Olsen	725934	Agent - Health	6/27/2023
Active	Moorman, Deborah Olsen	725934	Agent - Life	6/27/2023
Active	Omalley, Brian C	1272713	Agent - Health	6/28/2023
Active	Omalley, Brian C	1272713	Agent - Life	7/19/2023
Inactive	Parnow, Charles Joseph	757264	Agent - Health	6/21/2016	6/30/2022
Inactive	Parnow, Charles Joseph	757264	Agent - Life	6/21/2016	6/30/2022
Active	Parson, Trevis Gene	838848	Agent - Health	6/21/2016
Active	Parson, Trevis Gene	838848	Agent - Life	6/21/2016
Active	Reynolds, Michael	1244470	Agent - Health	7/17/2023
Active	Reynolds, Michael	1244470	Agent - Life	7/17/2023
Active	Rinderknecht, Stacie	627688	Agent - Health	6/14/2024
Active	Rinderknecht, Stacie	627688	Agent - Life	6/14/2024
Active	Rost, Randall K	1341550	Agent - Health	6/18/2024
Active	Rost, Randall K	1341550	Agent - Life	6/18/2024
Active	Sakamoto, Mayumi	903841	Agent - Life	11/21/2023
Active	Schwartz, Eric Bradley	1056584	Agent - Life	2/4/2020
Active	Shinohara, Laura	1022749	Agent - Health	8/22/2023
Active	Shinohara, Laura	1022749	Agent - Life	8/22/2023
Active	Stitzel, Brian	981825	Agent - Health	7/11/2023
Active	Stitzel, Brian	981825	Agent - Life	7/11/2023
Inactive	Thorpe, Kimberly	739823	Agent - Health	6/21/2016	10/27/2016
Inactive	Thorpe, Kimberly	739823	Agent - Life	6/21/2016	10/27/2016
Active	Vary, Betsy Ann	903458	Agent - Life	6/28/2023
Denied	Walsh, Elizabeth	581316	Agent - Life
Active	Wessel, Paula	913516	Agent - Health	6/28/2023
Active	Wessel, Paula	913516	Agent - Life	6/28/2023
Inactive	White, Jake	840502	Agent - Health	7/26/2023	11/28/2023
Inactive	White, Jake	840502	Agent - Life	7/26/2023	11/28/2023
Inactive	Wierkiewicz, David J	868183	Agent - Casualty	7/18/2023	9/25/2023
Inactive	Wierkiewicz, David J	868183	Agent - Health	6/21/2016	9/25/2023
Inactive	Wierkiewicz, David J	868183	Agent - Life	6/21/2016	9/25/2023
Inactive	Wierkiewicz, David J	868183	Agent - Property	7/18/2023	9/25/2023
Active	Zdrill, Kimberley Anne	1213766	Agent - Health	7/14/2023
Active	Zdrill, Kimberley Anne	1213766	Agent - Life	7/14/2023
Active	Zhou, Amanda	938476	Agent - Life	10/24/2023