DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Burlsworth, Grady A	DOIID	749214	NAIC NPN	2261248

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/11/2023	11/30/2025
Inactive	Non Resident	Agent	Life	9/11/2023	11/30/2025
* 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	9/16/2023	11/30/2025
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	9/16/2023	11/30/2025
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/16/2023	11/30/2025
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/31/2013	11/30/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/31/2013	11/30/2013
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	8/31/2013	11/30/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/31/2013	11/30/2013
Inactive	Humana Insurance Company	301104	Agent - Health	8/31/2013	11/30/2013
Inactive	Humana Insurance Company	301104	Agent - Life	8/31/2013	11/30/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/31/2013	11/30/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/31/2013	11/30/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Health	3/16/2011	2/24/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	3/16/2011	2/24/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/31/2013	11/30/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/31/2013	11/30/2013
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/16/2023	11/30/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Life	4/6/2011	8/2/2013
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	4/6/2011	8/2/2013