PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameBrokers Interstate Group LLCDOIID726877NAIC NPN15737282
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth4/21/2010 3/31/2026
ActiveNon ResidentAgentLife4/21/2010 3/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202603/31/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAccendo Insurance Company300312Agent - Health11/3/202211/17/2023
ActiveAccendo Insurance Company300312Agent - Life11/3/2022 
ActiveAetna Health Inc. (PA)660717Agent - Health10/12/2021 
ActiveAetna Health and Life Insurance Company300523Agent - Health11/3/2022 
ActiveAetna Health of Ohio Inc.1065035Agent - Health10/12/2021 
ActiveAetna Life Insurance Company301140Agent - Health10/12/2021 
InactiveAmerican Pioneer Life Insurance Company301782Agent - Health3/19/20119/13/2012
InactiveAmerican Pioneer Life Insurance Company301782Agent - Life3/19/20119/13/2012
InactiveAmerican Retirement Life Insurance Company706303Agent - Health1/4/201612/21/2018
InactiveAmerican Retirement Life Insurance Company706303Agent - Life6/10/201312/24/2015
ActiveAmerico Financial Life and Annuity Insurance Company300869Agent - Health11/16/2010 
InactiveAmerico Financial Life and Annuity Insurance Company300869Agent - Life11/16/20103/13/2015
ActiveCIGNA Health & Life Insurance Company301783Agent - Health11/24/2021 
InactiveCIGNA Health & Life Insurance Company301783Agent - Life8/10/201712/21/2018
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health8/23/2022 
InactiveColumbian Mutual Life Insurance Company301130Agent - Health6/18/20102/7/2019
InactiveColumbian Mutual Life Insurance Company301130Agent - Life6/18/20107/5/2013
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health11/3/2022 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Life11/3/2022 
InactiveFirst Health Life & Health Insurance Company301735Agent - Health12/28/201210/11/2018
ActiveForethought Life Insurance Company301407Agent - Health12/7/2010 
ActiveForethought Life Insurance Company301407Agent - Life12/7/2010 
InactiveGerber Life Insurance Company300529Agent - Health5/10/20101/27/2014
InactiveGerber Life Insurance Company300529Agent - Life5/10/20101/27/2014
ActiveHealthSpring National Health Insurance Company300235Agent - Health5/12/2022 
ActiveHealthspring Healthcare of Colorado, Inc.1098153Agent - Health12/29/2022 
InactiveIndependent Life Insurance Company301831Agent - Health3/19/201812/13/2018
InactiveIndependent Life Insurance Company301831Agent - Life3/19/201812/13/2018
ActiveIndependent Order of Foresters300743Agent - Life7/30/2013 
ActiveLoyal American Life Insurance Company301172Agent - Health1/13/2023 
InactiveMarquette National Life Insurance Company300117Agent - Health12/28/20109/13/2012
InactiveMarquette National Life Insurance Company300117Agent - Life12/28/20109/13/2012
ActiveMedco Containment Life Insurance Company301557Agent - Health1/21/2024 
InactiveMutual of Omaha Insurance Company301012Agent - Health6/8/20101/27/2014
ActiveNassau Life Insurance Company of Kansas300667Agent - Health11/23/2022 
InactiveNassau Life Insurance Company of Kansas300667Agent - Life11/22/201012/13/2012
InactiveNassau Life Insurance Company of Texas300872Agent - Health4/23/20109/13/2012
InactiveNassau Life Insurance Company of Texas300872Agent - Life4/23/20109/13/2012
ActiveNational Western Life Insurance Company301515Agent - Life4/27/2011 
InactiveOmaha Insurance Company751908Agent - Health3/30/20121/27/2014
InactivePacifiCare Life and Health Insurance Company301304Agent - Health8/19/201011/4/2011
InactivePennsylvania Life Insurance Company301321Agent - Health11/22/20103/31/2013
InactivePennsylvania Life Insurance Company301321Agent - Life11/22/20103/31/2013
InactiveSILAC Insurance Company300535Agent - Health10/10/201211/9/2020
InactiveSILAC Insurance Company300535Agent - Life10/10/20121/4/2022
ActiveSentinel Security Life Insurance Company935789Agent - Health10/17/2022 
ActiveSentinel Security Life Insurance Company935789Agent - Life10/17/2022 
ActiveSilverScript Insurance Company663526Agent - Health10/12/2021 
ActiveTier One Insurance Company301056Agent - Health3/28/2023 
ActiveTier One Insurance Company301056Agent - Life3/28/2023 
InactiveUnited World Life Insurance Company300532Agent - Health6/8/201012/15/2010
InactiveUnited of Omaha Life Insurance Company300156Agent - Health6/8/20101/27/2014
InactiveUnited of Omaha Life Insurance Company300156Agent - Life6/8/20101/27/2014
ActiveUnitedHealthcare Insurance Company300946Agent - Health8/23/2022 
InactiveUnitedHealthcare Insurance Company of America301552Agent - Health9/16/201612/20/2018
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health8/23/202212/22/2022
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health7/15/20185/21/2020
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health8/2/201112/5/2016
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health8/23/2022 
InactiveWellCare Prescription Insurance Inc.654329Agent - Health12/20/20185/13/2021
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveGraham, Mark Burnside 638756Agent - Health5/14/20182/23/2022
InactiveGraham, Mark Burnside 638756Agent - Life5/14/20182/23/2022
ActiveGraham, Matthew B 640480Agent - Health2/23/2022 
ActiveGraham, Matthew B 640480Agent - Life2/23/2022 
InactiveNorth, Timothy Owen 514133Agent - Health4/21/20105/14/2018
InactiveNorth, Timothy Owen 514133Agent - Life4/21/20105/14/2018

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