DEPARTMENT OF INSURANCE
Affiliations
NameAmerassure Marketing Group LLCDOIID715687NAIC NPN14124089
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth10/14/2009 3/31/2025
ActiveNon ResidentAgentLife10/14/2009 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
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202503/31/2025   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAetna Health Inc. (PA)660717Agent - Health9/5/2014 
ActiveAetna Health Insurance Company301583Agent - Health9/5/2014 
ActiveAetna Health of Ohio Inc.1065035Agent - Health9/15/2020 
ActiveAetna Life Insurance Company301140Agent - Health9/5/2014 
ActiveAetna Life Insurance Company301140Agent - Life9/5/2014 
InactiveAmerican Continental Insurance Company643130Agent - Health12/11/200911/13/2012
InactiveAmerican Continental Insurance Company643130Agent - Life12/11/200911/13/2012
InactiveAmerican Pioneer Life Insurance Company301782Agent - Health10/17/20109/13/2012
InactiveAmerican Retirement Life Insurance Company706303Agent - Health4/23/201512/24/2015
InactiveAmerican Retirement Life Insurance Company706303Agent - Life4/23/201512/24/2015
InactiveAthene Annuity & Life Assurance Company301798Agent - Life12/13/20128/13/2015
ActiveCIGNA Health & Life Insurance Company301783Agent - Health10/11/2016 
ActiveCIGNA Health & Life Insurance Company301783Agent - Life10/11/2016 
InactiveConnecticut General Life Insurance Company301333Agent - Health12/3/20096/11/2014
InactiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health12/10/20096/28/2013
InactiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Life12/10/20096/28/2013
ActiveCoventry Health and Life Insurance Company301771Agent - Health9/12/2014 
ActiveFirst Health Life & Health Insurance Company301735Agent - Health12/10/2010 
ActiveForethought Life Insurance Company301407Agent - Health3/14/2011 
ActiveForethought Life Insurance Company301407Agent - Life3/14/2011 
InactiveGerber Life Insurance Company300529Agent - Health2/15/20116/20/2016
InactiveGerber Life Insurance Company300529Agent - Life2/15/20116/20/2016
InactiveIndependent Order of Foresters300743Agent - Life10/29/200912/27/2021
InactiveMarquette National Life Insurance Company300117Agent - Health2/22/20119/13/2012
InactiveMarquette National Life Insurance Company300117Agent - Life2/22/20119/13/2012
InactiveMutual of Omaha Insurance Company301012Agent - Health2/15/20111/27/2014
InactiveNassau Life Insurance Company of Texas300872Agent - Health10/17/20109/13/2012
ActiveNational Western Life Insurance Company301515Agent - Life3/10/2011 
InactiveOmaha Insurance Company751908Agent - Health3/30/20121/27/2014
InactivePacifiCare Life and Health Insurance Company301304Agent - Health8/12/201011/4/2011
InactiveSILAC Insurance Company300535Agent - Health10/10/20129/23/2013
InactiveSILAC Insurance Company300535Agent - Life10/10/20129/23/2013
ActiveSilverScript Insurance Company663526Agent - Health5/12/2020 
InactiveUnited of Omaha Life Insurance Company300156Agent - Health2/15/20111/27/2014
InactiveUnited of Omaha Life Insurance Company300156Agent - Life2/15/20111/27/2014
InactiveUnitedHealthcare Insurance Company300946Agent - Health8/12/20105/21/2020
InactiveUnitedHealthcare Insurance Company of America301552Agent - Health9/11/201612/20/2018
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health8/5/20195/21/2020
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health7/15/20185/21/2020
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health8/2/201112/5/2016
InactiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health9/11/20155/21/2020
InactiveWellCare Prescription Insurance Inc.654329Agent - Health12/20/20185/13/2021
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveGraham, Mark Burnside 638756Agent - Health4/12/201812/15/2021
InactiveGraham, Mark Burnside 638756Agent - Life4/12/201812/15/2021
ActiveGraham, Matthew B 640480Agent - Health12/15/2021 
ActiveGraham, Matthew B 640480Agent - Life12/15/2021 
InactiveNorth, Timothy Owen 514133Agent - Health10/14/20094/13/2018
InactiveNorth, Timothy Owen 514133Agent - Life10/14/20094/13/2018

© Commonwealth of Kentucky. All rights reserved.