DEPARTMENT OF INSURANCE

Affiliations

Name	Lange, Timothy	DOIID	770467	NAIC NPN	16480213

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	12/9/2011	10/31/2017
Inactive	Non Resident	Agent	Life	12/9/2011	10/31/2017
* 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	American General Life Insurance Company	301585	Agent - Health	4/29/2016	10/31/2017
Inactive	American General Life Insurance Company	301585	Agent - Life	4/29/2016	10/31/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/7/2014	10/31/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/7/2014	10/31/2017
Inactive	Assurity Life Insurance Company	301099	Agent - Health	11/18/2013	12/9/2014
Inactive	Assurity Life Insurance Company	301099	Agent - Life	11/18/2013	12/9/2014
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	9/29/2016	10/31/2017
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	9/29/2016	10/31/2017
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	1/24/2013	4/19/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	1/24/2013	4/19/2016
Inactive	Golden Rule Insurance Company	301943	Agent - Health	5/17/2012	11/2/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	5/17/2012	11/2/2017
Inactive	HCC Life Insurance Company	301827	Agent - Health	10/12/2016	6/23/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	4/19/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	11/10/2012	4/19/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/9/2016	10/31/2017
Inactive	Humana Insurance Company	301104	Agent - Health	11/7/2012	4/19/2016
Inactive	Humana Insurance Company	301104	Agent - Life	11/7/2012	4/19/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/10/2012	4/19/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	5/13/2016	10/31/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	4/19/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/24/2013	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/24/2013	10/22/2015

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	11/7/2014	10/31/2017
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/7/2014	10/31/2017