DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	American Workers Ins Services Inc	DOIID	723800	NAIC NPN	8519803

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/16/2013		3/31/2026
Active	Non Resident	Agent	Life	7/16/2013		3/31/2026
* 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	5 Star Life Insurance Company	300673	Agent - Health	5/17/2017	4/15/2019
Inactive	5 Star Life Insurance Company	300673	Agent - Life	5/17/2017	4/15/2019
Inactive	ACE American Insurance Company	300625	Agent - Health	3/12/2016	8/20/2019
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/27/2019	12/16/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/27/2019	12/16/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/27/2019	12/16/2024
Inactive	Federal Insurance Company	301144	Agent - Health	12/29/2014	8/20/2019
Inactive	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	8/9/2023	3/13/2024

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Brock, Harold L	393846	Agent - Health	5/8/2019
Active	Brock, Harold L	393846	Agent - Life	5/8/2019
Inactive	Current, Clarence Jaren	719815	Agent - Health	3/2/2010	6/6/2011
Inactive	Current, Clarence Jaren	719815	Agent - Life	3/2/2010	6/6/2011
Inactive	Khalil, Jennifer Fatima	894480	Agent - Health	10/7/2015	2/28/2019
Inactive	Khalil, Jennifer Fatima	894480	Agent - Life	10/7/2015	2/28/2019
Inactive	Rabie, Shareef Mahmoud	739761	Agent - Health	7/16/2013	7/31/2015
Inactive	Rabie, Shareef Mahmoud	739761	Agent - Life	7/16/2013	7/31/2015