DEPARTMENT OF INSURANCE

Affiliations

Name	Ellis, Donna Rae	DOIID	728765	NAIC NPN	15777768

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Health	9/10/2010	6/30/2017
Inactive	Resident	Agent	Life	7/23/2010	6/30/2017
* 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	All Savers Insurance Company	301940	Agent - Health	6/10/2013	7/7/2017
Inactive	All Savers Insurance Company	301940	Agent - Life	6/10/2013	7/7/2017
Inactive	American United Life Insurance Company	300498	Agent - Health	10/9/2013	6/30/2017
Inactive	American United Life Insurance Company	300498	Agent - Life	10/9/2013	6/30/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Health	12/12/2012	4/25/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/12/2012	4/25/2017
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	8/3/2010	6/30/2017
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/4/2016	12/13/2016
Inactive	Dental Care Plus Inc.	301495	Agent - Health	9/16/2014	6/30/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/19/2013	6/30/2017
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	9/10/2014	6/30/2017
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	9/10/2014	6/30/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Health	7/9/2014	7/7/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	7/9/2014	7/7/2017
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	5/22/2014	6/30/2017
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	5/22/2014	6/30/2017
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	3/10/2017	7/30/2017
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	3/10/2017	7/30/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	2/7/2015	12/8/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	1/5/2016	12/13/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/19/2013	6/30/2017
Inactive	Humana Insurance Company	301104	Agent - Health	3/19/2013	6/30/2017
Inactive	Humana Insurance Company	301104	Agent - Life	3/19/2013	6/30/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/15/2015	6/30/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	2/7/2015	12/8/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	2/7/2015	12/8/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/7/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/11/2015	10/22/2015
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	3/17/2014	10/29/2015
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	6/21/2011	7/22/2016
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	6/21/2011	7/22/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/29/2017	7/7/2017
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	3/29/2017	7/7/2017
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	5/13/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	5/13/2015	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/28/2010	12/1/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	10/28/2010	12/1/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	9/14/2010	1/4/2013
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	10/28/2010	1/4/2013
Inactive	Assuredpartners NL, LLC	762387	Agent - Life	4/16/2012	5/2/2017
Inactive	Assuredpartners NL, LLC	762387	Agent - Health	4/16/2012	5/2/2017
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	12/27/2011	7/21/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/12/2012	6/30/2017
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/12/2012	6/30/2017
Inactive	Planchoice Inc.	400482	Agent - Life	12/8/2014	6/30/2017
Inactive	Planchoice Inc.	400482	Agent - Health	12/8/2014	6/30/2017