DEPARTMENT OF INSURANCE

Affiliations

Name	Pharmacy Enrollment Services, LLC	DOIID	747406	NAIC NPN	16001438

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	2/4/2011	3/31/2027
Active	Non Resident	Agent	Health	2/4/2011	3/31/2027
* 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
Active	Aetna Health Inc. (PA)	660717	Agent - Health	1/21/2020
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/15/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	1/21/2020
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	4/6/2011	5/2/2012
Inactive	American National Insurance Company	301861	Agent - Health	1/16/2012	6/3/2021
Inactive	American National Insurance Company	301861	Agent - Life	1/16/2012	3/15/2024
Inactive	American Pioneer Life Insurance Company	301782	Agent - Health	5/23/2011	9/13/2012
Inactive	American Pioneer Life Insurance Company	301782	Agent - Life	5/23/2011	9/13/2012
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	4/16/2012	8/13/2015
Active	First Health Life & Health Insurance Company	301735	Agent - Health	7/24/2013
Inactive	Gateway Health Plan of Ohio, Inc.	833424	Agent - Health	11/18/2017	1/1/2019
Inactive	Gerber Life Insurance Company	300529	Agent - Health	6/11/2013	8/13/2021
Inactive	Gerber Life Insurance Company	300529	Agent - Life	6/11/2013	8/13/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Health	8/20/2013	12/13/2014
Inactive	Golden Rule Insurance Company	301943	Agent - Life	8/20/2013	12/13/2014
Inactive	Independent Order of Foresters	300743	Agent - Life	12/13/2011	12/15/2018
Inactive	Marquette National Life Insurance Company	300117	Agent - Health	5/23/2011	9/13/2012
Inactive	Marquette National Life Insurance Company	300117	Agent - Life	5/23/2011	9/13/2012
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Health	5/23/2011	9/13/2012
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Life	5/23/2011	9/13/2012
Active	National Western Life Insurance Company	301515	Agent - Life	4/29/2011
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	2/15/2011	10/31/2011
Inactive	SILAC Insurance Company	300535	Agent - Health	10/10/2012	9/23/2013
Inactive	SILAC Insurance Company	300535	Agent - Life	10/10/2012	9/23/2013
Active	Sentinel Security Life Insurance Company	935789	Agent - Health	10/19/2022
Active	Sentinel Security Life Insurance Company	935789	Agent - Life	10/19/2022
Active	SilverScript Insurance Company	663526	Agent - Health	1/21/2020
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	2/15/2011	6/5/2019
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/11/2016	12/20/2018
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	6/5/2019
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	2/15/2011	12/5/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/10/2015	6/5/2019

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Graham, Mark Burnside	638756	Agent - Health	6/11/2018	3/31/2022
Inactive	Graham, Mark Burnside	638756	Agent - Life	6/11/2018	3/31/2022
Active	Graham, Matthew B	640480	Agent - Health	12/17/2024
Active	Graham, Matthew B	640480	Agent - Life	12/17/2024
Inactive	North, Timothy Owen	514133	Agent - Health	2/4/2011	6/11/2018
Inactive	North, Timothy Owen	514133	Agent - Life	2/4/2011	6/11/2018
Inactive	Ramsey, Ryan	1002323	Agent - Health	3/31/2022	12/17/2024
Inactive	Ramsey, Ryan	1002323	Agent - Life	3/31/2022	12/17/2024