DEPARTMENT OF INSURANCE

Affiliations

Name	Brokers Interstate Group LLC	DOIID	726877	NAIC NPN	15737282

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	4/21/2010	3/31/2026
Active	Non Resident	Agent	Life	4/21/2010	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	Accendo Insurance Company	300312	Agent - Health	11/3/2022	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	11/3/2022
Active	Aetna Health Inc. (PA)	660717	Agent - Health	10/12/2021
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	11/3/2022
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	10/12/2021
Active	Aetna Life Insurance Company	301140	Agent - Health	10/12/2021
Inactive	American Pioneer Life Insurance Company	301782	Agent - Health	3/19/2011	9/13/2012
Inactive	American Pioneer Life Insurance Company	301782	Agent - Life	3/19/2011	9/13/2012
Inactive	American Retirement Life Insurance Company	706303	Agent - Health	1/4/2016	12/21/2018
Inactive	American Retirement Life Insurance Company	706303	Agent - Life	6/10/2013	12/24/2015
Active	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	11/16/2010
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	11/16/2010	3/13/2015
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	11/24/2021
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Life	8/10/2017	12/21/2018
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	8/23/2022
Active	Cigna Healthcare of Colorado, Inc.	1098153	Agent - Health	12/29/2022
Active	Cigna National Health Insurance Company	300235	Agent - Health	5/12/2022
Inactive	Columbian Mutual Life Insurance Company	301130	Agent - Health	6/18/2010	2/7/2019
Inactive	Columbian Mutual Life Insurance Company	301130	Agent - Life	6/18/2010	7/5/2013
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	11/3/2022
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	11/3/2022
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	12/28/2012	10/11/2018
Active	Forethought Life Insurance Company	301407	Agent - Health	12/7/2010
Active	Forethought Life Insurance Company	301407	Agent - Life	12/7/2010
Inactive	Gerber Life Insurance Company	300529	Agent - Health	5/10/2010	1/27/2014
Inactive	Gerber Life Insurance Company	300529	Agent - Life	5/10/2010	1/27/2014
Inactive	Independent Life Insurance Company	301831	Agent - Health	3/19/2018	12/13/2018
Inactive	Independent Life Insurance Company	301831	Agent - Life	3/19/2018	12/13/2018
Active	Independent Order of Foresters	300743	Agent - Life	7/30/2013
Active	Loyal American Life Insurance Company	301172	Agent - Health	1/13/2023
Inactive	Marquette National Life Insurance Company	300117	Agent - Health	12/28/2010	9/13/2012
Inactive	Marquette National Life Insurance Company	300117	Agent - Life	12/28/2010	9/13/2012
Active	Medco Containment Life Insurance Company	301557	Agent - Health	1/21/2024
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	6/8/2010	1/27/2014
Active	Nassau Life Insurance Company of Kansas	300667	Agent - Health	11/23/2022
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Life	11/22/2010	12/13/2012
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Health	4/23/2010	9/13/2012
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Life	4/23/2010	9/13/2012
Active	National Western Life Insurance Company	301515	Agent - Life	4/27/2011
Inactive	Omaha Insurance Company	751908	Agent - Health	3/30/2012	1/27/2014
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	8/19/2010	11/4/2011
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Health	11/22/2010	3/31/2013
Inactive	Pennsylvania Life Insurance Company	301321	Agent - Life	11/22/2010	3/31/2013
Inactive	SILAC Insurance Company	300535	Agent - Health	10/10/2012	11/9/2020
Inactive	SILAC Insurance Company	300535	Agent - Life	10/10/2012	1/4/2022
Active	Sentinel Security Life Insurance Company	935789	Agent - Health	10/17/2022
Active	Sentinel Security Life Insurance Company	935789	Agent - Life	10/17/2022
Active	SilverScript Insurance Company	663526	Agent - Health	10/12/2021
Active	Tier One Insurance Company	301056	Agent - Health	3/28/2023
Active	Tier One Insurance Company	301056	Agent - Life	3/28/2023
Inactive	United World Life Insurance Company	300532	Agent - Health	6/8/2010	12/15/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	6/8/2010	1/27/2014
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	6/8/2010	1/27/2014
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	8/23/2022
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/16/2016	12/20/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/23/2022	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	5/21/2020
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/2/2011	12/5/2016
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	8/23/2022
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	12/20/2018	5/13/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Graham, Mark Burnside	638756	Agent - Health	5/14/2018	2/23/2022
Inactive	Graham, Mark Burnside	638756	Agent - Life	5/14/2018	2/23/2022
Active	Graham, Matthew B	640480	Agent - Health	2/23/2022
Active	Graham, Matthew B	640480	Agent - Life	2/23/2022
Inactive	North, Timothy Owen	514133	Agent - Health	4/21/2010	5/14/2018
Inactive	North, Timothy Owen	514133	Agent - Life	4/21/2010	5/14/2018