DEPARTMENT OF INSURANCE

Affiliations

Name	Mullady, Deryck James	DOIID	722780	NAIC NPN	15094361

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	2/11/2010	8/31/2021
Inactive	Non Resident	Agent	Life	2/11/2010	8/31/2021
* 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	ACE Property and Casualty Insurance Company	300520	Agent - Health	4/2/2020	8/31/2021
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	10/31/2011	10/26/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/31/2011	10/26/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Life	10/31/2011	10/26/2016
Inactive	Banner Life Insurance Company	301696	Agent - Life	4/4/2013	11/30/2015
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	2/17/2010	2/10/2016
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	2/17/2010	2/10/2016
Inactive	Combined Insurance Company of America	301472	Agent - Health	7/19/2018	8/31/2021
Inactive	Combined Insurance Company of America	301472	Agent - Life	7/19/2018	8/31/2021
Inactive	Continental American Insurance Company	301700	Agent - Health	3/15/2016	9/30/2021
Inactive	Continental American Insurance Company	301700	Agent - Life	3/15/2016	9/30/2021
Inactive	Continental General Insurance Company	300691	Agent - Health	8/9/2018	1/25/2019
Inactive	Continental General Insurance Company	300691	Agent - Life	8/9/2018	1/25/2019
Inactive	Humana Insurance Company	301104	Agent - Health	12/1/2016	9/21/2018
Inactive	Humana Insurance Company	301104	Agent - Life	12/1/2016	9/21/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/14/2013	8/9/2018
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/14/2013	8/9/2018
Inactive	ManhattanLife Insurance and Annuity Company	301795	Agent - Health	4/8/2019	8/31/2021
Inactive	ManhattanLife Insurance and Annuity Company	301795	Agent - Life	4/8/2019	8/31/2021
Inactive	Trustmark Insurance Company	300317	Agent - Health	10/14/2017	8/31/2021
Inactive	Trustmark Insurance Company	300317	Agent - Life	10/14/2017	8/31/2021
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/7/2011	10/31/2013
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	10/7/2011	10/31/2013
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/7/2011	10/31/2013
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	10/7/2011	10/31/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBISA Reaquisitian Corp	547026	Agent - Life	10/14/2011	8/31/2021
Inactive	CBISA Reaquisitian Corp	547026	Agent - Health	10/14/2011	8/31/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/6/2013	8/31/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/6/2013	8/31/2021