DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	KBA Benefit Solutions, LLC	DOIID	774036	NAIC NPN	16526917

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	2/3/2012		3/31/2026
Active	Resident	Agent	Health	2/3/2012		3/31/2026
* 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	Baptist Health Plan, Inc.	300157	Agent - Health	2/14/2013	3/31/2019
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	8/14/2012	11/9/2015
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	8/14/2012	11/9/2015
Active	Guardian Life Insurance Company of America	301316	Agent - Health	8/14/2012
Active	Guardian Life Insurance Company of America	301316	Agent - Life	8/14/2012

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Mattingly, Lisa M	329804	Agent - Health	2/3/2012
Active	Mattingly, Lisa M	329804	Agent - Life	2/3/2012