DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Thillman, David Russell	DOIID	770944	NAIC NPN	16235666

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	12/16/2011	9/30/2014
Inactive	Non Resident	Agent	Life	12/16/2011	9/30/2014
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	4/13/2012	9/30/2014
Inactive	Aetna Life Insurance Company	301140	Agent - Health	4/13/2012	9/30/2014
Inactive	Aetna Life Insurance Company	301140	Agent - Life	4/13/2012	9/30/2014
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	1/24/2013	10/15/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	1/24/2013	10/15/2013
Inactive	Golden Rule Insurance Company	301943	Agent - Health	1/9/2012	6/21/2012
Inactive	Golden Rule Insurance Company	301943	Agent - Life	1/9/2012	6/21/2012
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	12/18/2012	10/15/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/18/2012	10/15/2013
Inactive	Humana Insurance Company	301104	Agent - Health	12/14/2012	10/15/2013
Inactive	Humana Insurance Company	301104	Agent - Life	12/14/2012	10/15/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/18/2012	10/15/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/18/2012	10/15/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/24/2013	10/15/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/24/2013	10/15/2013
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	2/15/2012	7/5/2012
Inactive	Time Insurance Company	300683	Agent - Health	9/17/2012	12/25/2013
Inactive	Time Insurance Company	300683	Agent - Life	9/17/2012	12/25/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Zoom Health Inc	758495	Agent - Life	2/16/2012	3/31/2013
Inactive	Zoom Health Inc	758495	Agent - Health	2/16/2012	3/31/2013