DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Tristar Benefit Administrators Inc	DOIID	751910	NAIC NPN	15851565

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	11/13/2015		3/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Administrator	01/15/2025	03/31/2025	01/24/2025	01/24/2025	Yes

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Buchwald, Lynette R	1030669	Administrator - Not Applicable	12/16/2021
Inactive	Demarco, Frank J	686405	Administrator - Not Applicable	4/12/2011	3/31/2012
Inactive	Devault, Lori	719793	Administrator - Not Applicable	10/5/2011	3/4/2013
Inactive	Jones, Jody	526854	Administrator - Not Applicable	10/5/2011	12/31/2012
Inactive	Sand, Sue N	1030703	Administrator - Not Applicable	10/30/2019	9/30/2021
Inactive	Sleiter, Ty J	803217	Administrator - Not Applicable	11/13/2015	7/31/2019
Inactive	Wentworth, Patricia	711123	Administrator - Not Applicable	10/5/2011	5/31/2014