DEPARTMENT OF INSURANCE

Affiliations

Name	Coverage One Ins Group LLC	DOIID	755584	NAIC NPN	16185632

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	6/6/2011	3/31/2027
Active	Non Resident	Agent	Life	6/6/2011	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
Agent	01/15/2025	03/31/2025	02/04/2025	02/04/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	ACE American Insurance Company	300625	Agent - Health	10/3/2016	12/30/2022
Active	AXA XL Insurance Company Americas	300979	Agent - Health	6/13/2017
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	10/22/2019
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	10/1/2019
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/25/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	10/22/2019
Active	Aetna Life Insurance Company	301140	Agent - Life	10/22/2019
Active	American General Life Insurance Company	301585	Agent - Health	1/10/2012
Active	American General Life Insurance Company	301585	Agent - Life	1/10/2012
Active	Ameritas Life Insurance Corporation	300126	Agent - Health	10/7/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	11/8/2019	4/6/2021
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	6/16/2023	2/3/2025
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	6/16/2023	2/3/2025
Active	Cigna Healthcare of Colorado, Inc.	1098153	Agent - Health	2/6/2025
Inactive	Clear Spring Health Insurance Company	301686	Agent - Health	2/28/2023	12/19/2024
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Health	6/25/2015	7/17/2019
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Life	6/25/2015	7/17/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Health	1/3/2020	4/6/2021
Inactive	Companion Life Insurance Company	300191	Agent - Health	3/16/2015	4/16/2024
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	10/1/2019
Inactive	Federal Insurance Company	301144	Agent - Health	10/3/2016	12/30/2022
Active	Gerber Life Insurance Company	300529	Agent - Health	1/24/2022
Active	Gerber Life Insurance Company	300529	Agent - Life	1/24/2022
Active	Golden Rule Insurance Company	301943	Agent - Health	8/21/2014
Active	Golden Rule Insurance Company	301943	Agent - Life	8/21/2014
Inactive	HCC Life Insurance Company	301827	Agent - Health	11/11/2016	6/12/2017
Active	HealthSpring Life and Health Insurance Company, Inc.	684899	Agent - Health	2/6/2025
Inactive	Lasso Healthcare Insurance Company	1022651	Agent - Health	6/16/2023	12/22/2023
Active	Medco Containment Life Insurance Company	301557	Agent - Health	2/6/2025
Inactive	Medico Corp Life Insurance Company	301777	Agent - Health	7/29/2016	11/9/2017
Inactive	Medico Corp Life Insurance Company	301777	Agent - Life	7/29/2016	11/9/2017
Inactive	Medico Insurance Company	301559	Agent - Health	1/2/2018	12/26/2018
Inactive	Medico Insurance Company	301559	Agent - Life	1/2/2018	12/26/2018
Inactive	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	5/16/2023	8/8/2024
Active	National Health Insurance Company	300554	Agent - Health	6/18/2015
Active	National Health Insurance Company	300554	Agent - Life	6/18/2015
Active	SilverScript Insurance Company	663526	Agent - Health	10/22/2019
Active	Tier One Insurance Company	301056	Agent - Health	10/7/2021
Inactive	Time Insurance Company	300683	Agent - Health	8/18/2014	11/15/2019
Inactive	Time Insurance Company	300683	Agent - Life	8/18/2014	11/15/2019
Inactive	Unified Life Insurance Company	543169	Agent - Health	11/9/2016	12/21/2018
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	9/25/2019
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/25/2019	12/22/2022
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	3/21/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	3/21/2015	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/25/2019	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/25/2019
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	2/17/2022
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	4/7/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Cruz, Laurel J	835747	Agent - Health	8/8/2016	6/30/2018
Inactive	Ettinger, Beth	755017	Agent - Health	8/8/2016	7/31/2017
Inactive	Ettinger, Beth	755017	Agent - Life	8/8/2016	7/31/2017
Active	Ettinger, David Harry	749988	Agent - Health	7/8/2019
Active	Ettinger, David Harry	749988	Agent - Life	7/8/2019
Inactive	Hurley, Jill J	785677	Agent - Health	8/8/2016	5/31/2017
Inactive	Hurley, Jill J	785677	Agent - Life	8/8/2016	5/31/2017
Inactive	Kinkead, Kimberly A	958489	Agent - Health	12/30/2019	9/30/2021
Inactive	Kinkead, Kimberly A	958489	Agent - Life	12/30/2019	9/30/2021
Active	Lanneaux, Racheal J	1059466	Agent - Health	12/30/2019
Active	Lanneaux, Racheal J	1059466	Agent - Life	12/30/2019
Inactive	Lawery, Kenyatta	833155	Agent - Health	8/8/2016	8/31/2016
Inactive	Lawery, Kenyatta	833155	Agent - Life	8/8/2016	8/31/2016
Inactive	Mathews, Joshua C	634688	Agent - Health	8/8/2016	11/30/2023
Inactive	Mathews, Joshua C	634688	Agent - Life	8/8/2016	7/16/2021
Inactive	Mcgriff, Patricia R	1049696	Agent - Health	12/30/2019	6/30/2021
Inactive	Mchale, Caitlin	1057733	Agent - Health	12/30/2019	11/30/2022
Inactive	Rakocevic, Velimir Dragic	744155	Agent - Health	8/8/2016	2/28/2022
Inactive	Rakocevic, Velimir Dragic	744155	Agent - Life	8/8/2016	2/28/2022
Inactive	Rivera, Antonio	790840	Agent - Health	8/8/2016	10/31/2022
Inactive	Rivera, Antonio	790840	Agent - Life	8/8/2016	10/31/2022
Inactive	Roberts, Ricardo	1065737	Agent - Health	12/30/2019	5/31/2024
Inactive	Rubin, Rebecca	913867	Agent - Health	8/30/2016	6/30/2019
Inactive	Rubin, Rebecca	913867	Agent - Life	8/30/2016	6/30/2019
Inactive	Scheibner, Samantha M	828666	Agent - Health	8/8/2016	5/31/2018
Inactive	Scheibner, Samantha M	828666	Agent - Life	8/8/2016	5/31/2018
Inactive	Thompson, Sheena V	703899	Agent - Health	8/8/2016	1/31/2019
Inactive	Thompson, Sheena V	703899	Agent - Life	8/8/2016	1/31/2019
Inactive	Wilson, Shaliece	830825	Agent - Health	8/8/2016	3/31/2017
Inactive	Wilson, Shaliece	830825	Agent - Life	8/8/2016	3/31/2017
Inactive	Wilson, Warren A	1031374	Agent - Health	12/30/2019	4/30/2023
Inactive	Wilson, Warren A	1031374	Agent - Life	12/30/2019	4/30/2023