DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Cosby, Kelly C	DOIID	773083	NAIC NPN	16514842

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	2/8/2012	6/1/2015
Inactive	Resident	Agent	Life	2/8/2012	6/1/2015
* 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	Anthem Life Insurance Company	301209	Agent - Health	2/29/2012	6/1/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	2/29/2012	6/1/2015
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	3/19/2013	6/1/2015
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	3/19/2013	6/1/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	12/10/2014	6/1/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/10/2014	6/1/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	2/26/2013	12/5/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	2/29/2012	6/1/2015
Inactive	Humana Insurance Company	301104	Agent - Health	2/27/2012	6/1/2015
Inactive	Humana Insurance Company	301104	Agent - Life	2/27/2012	6/1/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	2/29/2012	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	2/29/2012	12/5/2014
Inactive	HumanaDental Insurance Company	301457	Agent - Health	2/29/2012	12/19/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	2/29/2012	12/19/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/10/2014	6/1/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/10/2014	6/1/2015
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	10/8/2013	6/1/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	11/21/2014	6/1/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Life	2/29/2012	6/1/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	2/29/2012	6/1/2015
Inactive	Life Assoc Inc	398569	Agent - Life	2/5/2013	6/1/2015
Inactive	Life Assoc Inc	398569	Agent - Health	2/5/2013	6/1/2015