DEPARTMENT OF INSURANCE

Affiliations

Name	Dergalis Assoc LLC	DOIID	711218	NAIC NPN	9599109

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	8/13/2009	3/31/2027
Active	Non Resident	Agent	Life	8/13/2009	3/31/2027
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	3/2/2011	12/5/2012
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	3/2/2011	12/5/2012
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/1/2013
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/1/2013	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/1/2013	4/15/2025
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/29/2014	12/8/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/29/2014	12/8/2015
Inactive	Gerber Life Insurance Company	300529	Agent - Health	12/22/2009	12/26/2012
Inactive	Gerber Life Insurance Company	300529	Agent - Life	12/22/2009	12/26/2012
Inactive	Golden Rule Insurance Company	301943	Agent - Health	4/29/2015	1/10/2019
Inactive	Golden Rule Insurance Company	301943	Agent - Life	4/29/2015	1/10/2019
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/20/2012	5/2/2017
Inactive	Humana Insurance Company	301104	Agent - Health	8/20/2012	5/2/2017
Inactive	Humana Insurance Company	301104	Agent - Life	8/20/2012	5/2/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/29/2014	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/29/2014	12/8/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/29/2014	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/29/2014	10/22/2015
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	4/29/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	4/29/2015	11/4/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dergalis, Alexis	582114	Agent - Health	8/13/2009
Active	Dergalis, Alexis	582114	Agent - Life	8/13/2009