DEPARTMENT OF INSURANCE

Affiliations

Name	Ghrist, Tiffany R	DOIID	736577	NAIC NPN	15933856

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	9/9/2010	8/31/2015
Inactive	Non Resident	Agent	Life	9/9/2010	8/31/2015
* 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	11/8/2010	7/10/2013
Inactive	Aetna Life Insurance Company	301140	Agent - Health	11/8/2010	7/10/2013
Inactive	Aetna Life Insurance Company	301140	Agent - Life	11/8/2010	7/10/2013
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/10/2013	9/1/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/10/2013	9/1/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	2/10/2012	8/21/2012
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	11/29/2010	8/31/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/25/2011	8/21/2012
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	11/29/2010	8/31/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/27/2010	8/21/2012
Inactive	Humana Insurance Company	301104	Agent - Health	9/15/2010	8/21/2012
Inactive	Humana Insurance Company	301104	Agent - Life	9/15/2010	8/21/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/27/2010	8/21/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/27/2010	8/21/2012
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	10/12/2010	8/4/2011
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	9/20/2010	11/5/2011
Inactive	SilverScript Insurance Company	663526	Agent - Health	11/10/2010	1/26/2015
Inactive	Sterling Life Insurance Company	301947	Agent - Health	10/13/2011	10/21/2012
Inactive	Sterling Life Insurance Company	301947	Agent - Life	10/13/2011	10/21/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	10/12/2010	8/4/2011
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	10/12/2010	8/4/2011
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/20/2010	6/18/2012
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	9/8/2011	6/18/2012
Inactive	Washington National Insurance Company	300587	Agent - Health	9/29/2011	7/11/2012
Inactive	Washington National Insurance Company	300587	Agent - Life	9/29/2011	7/11/2012
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	11/18/2010	11/17/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Alorica Customer Care, Inc.	800938	Agent - Life	10/2/2013	3/10/2014
Inactive	Alorica Customer Care, Inc.	800938	Agent - Health	10/2/2013	3/10/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/17/2013	9/1/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/17/2013	9/1/2015