DEPARTMENT OF INSURANCE

Affiliations

Name	Ford, Kiyeeda Diana	DOIID	731802	NAIC NPN	11516959

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	8/20/2013	8/14/2015
Inactive	Non Resident	Agent	Property	3/29/2016	6/30/2018
Inactive	Non Resident	Agent	Casualty	3/29/2016	6/30/2018
Inactive	Non Resident	Agent	Health	8/20/2013	8/14/2015
Inactive	Non Resident	Staff Adjuster	Property & Casualty	7/23/2010	6/30/2012
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	9/11/2013	10/1/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/11/2013	10/1/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Life	9/11/2013	10/1/2015
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	9/3/2013	8/14/2015
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Life	9/3/2013	8/14/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	1/1/2014	1/31/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	9/3/2013	6/11/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	9/3/2013	6/11/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	1/1/2014	1/31/2014
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/16/2013	1/31/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/16/2013	1/31/2014
Inactive	Humana Insurance Company	301104	Agent - Health	12/4/2013	1/31/2014
Inactive	Humana Insurance Company	301104	Agent - Life	12/4/2013	1/31/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/4/2013	1/31/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/4/2013	1/31/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/1/2014	1/31/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/1/2014	1/31/2014
Inactive	Medco Containment Life Insurance Company	301557	Agent - Health	9/10/2013	7/7/2015
Inactive	Permanent General Assurance Corporation of Ohio	709250	Agent - Casualty	4/8/2016	12/13/2016
Inactive	SilverScript Insurance Company	663526	Agent - Health	1/31/2014	8/14/2015
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/7/2013	2/3/2014
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	11/7/2013	2/3/2014
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	12/27/2013	12/22/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	General Automobile Ins Services Inc	706632	Agent - Casualty	4/14/2016	12/13/2016