DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Monteblanco, Jay L	DOIID	750794	NAIC NPN	3995616

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/25/2011	7/31/2013
Inactive	Non Resident	Agent	Life	3/25/2011	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 Life Insurance Company	301209	Agent - Health	4/13/2011	7/31/2013
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/13/2011	7/31/2013
Inactive	Standard Insurance Company	300185	Agent - Health	10/30/2012	7/31/2013
Inactive	Standard Insurance Company	300185	Agent - Life	10/30/2012	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	Designated Agent Company Inc.	681257	Agent - Life	4/13/2011	7/31/2013
Inactive	Designated Agent Company Inc.	681257	Agent - Health	4/13/2011	7/31/2013
Inactive	Medlink Inc	400721	Agent - Life	4/13/2011	7/31/2013
Inactive	Medlink Inc	400721	Agent - Health	4/13/2011	7/31/2013