DEPARTMENT OF INSURANCE

Affiliations

Name	Workplace Benefits Group LLC	DOIID	718995	NAIC NPN	15390928

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Life	6/27/2023	3/31/2025
Active	Resident	Agent	Health	6/27/2023	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	Auto-Owners Life Insurance Company	301368	Agent - Health	8/24/2012	3/31/2023
Inactive	Auto-Owners Life Insurance Company	301368	Agent - Life	8/24/2012	3/31/2023
Inactive	Banner Life Insurance Company	301696	Agent - Life	9/11/2020	3/31/2023
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	5/27/2010	8/20/2012
Inactive	CompBenefits Insurance Company	301864	Agent - Health	5/27/2010	8/20/2012
Inactive	CompBenefits Insurance Company	301864	Agent - Life	5/27/2010	8/20/2012
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	1/25/2011	9/12/2013
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	1/25/2011	9/12/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	5/27/2010	8/20/2012
Inactive	Gerber Life Insurance Company	300529	Agent - Health	2/26/2010	12/17/2012
Inactive	Gerber Life Insurance Company	300529	Agent - Life	2/26/2010	12/17/2012
Inactive	Grange Life Insurance Company	300128	Agent - Health	5/23/2014	3/31/2021
Inactive	Grange Life Insurance Company	300128	Agent - Life	5/23/2014	3/31/2021
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	8/4/2023
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	8/4/2023
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	5/27/2010	8/20/2012
Inactive	Humana Insurance Company	301104	Agent - Health	5/27/2010	8/20/2012
Inactive	Humana Insurance Company	301104	Agent - Life	5/27/2010	8/20/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/27/2010	8/20/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	5/27/2010	8/20/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Health	5/27/2010	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	5/27/2010	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	5/27/2010	8/20/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	5/27/2010	8/20/2012
Inactive	Liberty Insurance Underwriters Inc.	301391	Agent - Health	6/18/2014	3/31/2023
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Life	11/23/2010	12/26/2012
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	1/25/2010	12/26/2012
Inactive	Omaha Insurance Company	751908	Agent - Health	6/7/2012	6/24/2013
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	11/9/2011	1/29/2016
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	11/9/2011	1/29/2016
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	1/25/2010	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	1/25/2010	12/26/2012

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Chesnut, Stanley	813099	Agent - Health	8/7/2014	10/13/2015
Inactive	Chesnut, Stanley	813099	Agent - Life	8/7/2014	10/13/2015
Active	Coleman, Jessica Marie	582204	Agent - Life	6/27/2023
Inactive	Jenkins, William Kelly	307860	Agent - Health	10/19/2011	8/8/2014
Inactive	Jenkins, William Kelly	307860	Agent - Life	2/14/2013	8/8/2014
Active	Smith, Bradley L	710483	Agent - Health	6/27/2023
Inactive	Smith, Bradley L	710483	Agent - Life	12/29/2009	3/31/2023