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	3/31/2025
Active	Non Resident	Agent	Life	8/13/2009	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
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
Active	Anthem Life Insurance Company	301209	Agent - Health	11/1/2013
Active	Anthem Life Insurance Company	301209	Agent - Life	11/1/2013
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