DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	IPA Family, LLC	DOIID	766836	NAIC NPN	14286907

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/18/2011	3/31/2017
Inactive	Non Resident	Agent	Life	10/18/2011	3/31/2017
* 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	Banner Life Insurance Company	301696	Agent - Life	2/11/2015	3/31/2017
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	7/22/2014	3/31/2017
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	7/22/2014	3/31/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Health	1/26/2015	4/4/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	1/26/2015	4/4/2017
Inactive	Independence American Insurance Company	524747	Agent - Health	12/12/2013	5/26/2017
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	12/11/2013	5/30/2017
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Life	12/11/2013	5/30/2017
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	12/11/2013	5/30/2017
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	12/11/2013	5/30/2017
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	3/30/2015	3/31/2017
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	3/30/2015	3/31/2017
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/5/2015	2/14/2017

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Keeler, David Wayne	356537	Agent - Health	5/19/2015	3/31/2017
Inactive	Keeler, David Wayne	356537	Agent - Life	5/19/2015	3/31/2017
Inactive	Smedsrud, Jeff C	655067	Agent - Health	10/18/2011	8/23/2013
Inactive	Smedsrud, Jeff C	655067	Agent - Life	10/18/2011	8/23/2013