DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mason, Myrtice R	DOIID	736287	NAIC NPN	9360218

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/4/2010	7/31/2013
Inactive	Non Resident	Agent	Life	9/4/2010	7/31/2013
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/16/2010	7/20/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/16/2010	7/20/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/16/2010	7/20/2012
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	11/23/2010	7/31/2013
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	11/23/2010	7/31/2013
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	11/23/2010	7/31/2013
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	11/23/2010	7/31/2013
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Health	12/6/2010	7/31/2013
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Life	12/6/2010	7/31/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Corporate Call Center, Inc	695480	Agent - Health	10/19/2010	7/31/2013
Inactive	Corporate Call Center, Inc	695480	Agent - Life	10/19/2010	7/31/2013
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/16/2010	7/20/2012
Inactive	Designated Agent Company Inc.	681257	Agent - Life	10/16/2010	7/20/2012