DEPARTMENT OF INSURANCE

Affiliations

Name	American Service Insurance Agency LLC	DOIID	776503	NAIC NPN	16460754

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Administrator	Not Applicable	5/25/2021	7/28/2022
Denied	Non Resident	Agent	Casualty
Denied	Non Resident	Agent	Property
Inactive	Non Resident	Agent	Life	3/6/2012	3/31/2024
Inactive	Non Resident	Agent	Health	3/6/2012	3/31/2024
* 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	Accendo Insurance Company	300312	Agent - Life	6/10/2020	3/31/2024
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	9/30/2012	7/8/2021
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	8/10/2016	3/31/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/30/2012	7/8/2021
Inactive	Aetna Life Insurance Company	301140	Agent - Life	9/30/2012	7/8/2021
Inactive	American Retirement Life Insurance Company	706303	Agent - Health	7/14/2015	11/6/2016
Inactive	American Retirement Life Insurance Company	706303	Agent - Life	7/14/2015	11/6/2016
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	8/23/2016	12/21/2018
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	8/23/2016	5/30/2017
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/1/2021	3/31/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/1/2021	3/31/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/1/2021	3/31/2024
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	10/2/2016	12/22/2020
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	11/5/2013	12/5/2014
Inactive	Companion Life Insurance Company	300191	Agent - Health	4/14/2014	10/26/2018
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018	3/31/2024
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	11/5/2013	12/5/2014
Inactive	Federal Insurance Company	301144	Agent - Health	7/9/2019	9/27/2021
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	7/13/2015	7/8/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Health	3/4/2014	1/22/2018
Inactive	Golden Rule Insurance Company	301943	Agent - Life	3/4/2014	1/22/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	11/5/2013	12/5/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/5/2013	12/5/2014
Inactive	Humana Insurance Company	301104	Agent - Health	11/5/2013	4/13/2015
Inactive	Humana Insurance Company	301104	Agent - Life	11/5/2013	4/13/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/5/2013	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/5/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/5/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/5/2013	12/5/2014
Inactive	ManhattanLife Insurance and Annuity Company	301795	Agent - Health	5/28/2013	3/16/2016
Inactive	ManhattanLife Insurance and Annuity Company	301795	Agent - Life	5/28/2013	7/13/2016
Inactive	Medico Corp Life Insurance Company	301777	Agent - Health	7/6/2015	12/1/2017
Inactive	Medico Corp Life Insurance Company	301777	Agent - Life	7/6/2015	12/1/2017
Inactive	Medico Insurance Company	301559	Agent - Health	6/25/2015	12/1/2017
Inactive	Medico Insurance Company	301559	Agent - Life	6/25/2015	12/1/2017
Inactive	Time Insurance Company	300683	Agent - Health	8/21/2012	11/15/2019
Inactive	Time Insurance Company	300683	Agent - Life	8/21/2012	11/15/2019
Inactive	Unified Life Insurance Company	543169	Agent - Health	4/30/2015	4/6/2018
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/13/2016	12/7/2017
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/13/2016	12/7/2017
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	1/28/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	1/28/2015	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/5/2015	2/14/2017
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/13/2016	12/7/2017

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arriaga, Darla Joline	737474	Agent - Health	6/14/2016	2/12/2019
Inactive	Arriaga, Darla Joline	737474	Agent - Life	6/14/2016	2/12/2019
Inactive	Bowman, Krystle	852478	Agent - Health	6/14/2016	5/31/2017
Inactive	Bowman, Krystle	852478	Agent - Life	6/14/2016	5/31/2017
Inactive	Brown, Kristin Arline	807184	Agent - Health	6/14/2016	1/18/2018
Inactive	Bruner, Dustin Todd	851424	Agent - Health	6/14/2016	3/31/2024
Inactive	Castaneda, Ezekiel	892062	Agent - Health	6/14/2016	4/30/2017
Inactive	Castaneda, Ezekiel	892062	Agent - Life	6/14/2016	4/30/2017
Inactive	Duarte, Maria Mercedes	803265	Agent - Health	6/14/2016	2/28/2023
Inactive	Duarte, Maria Mercedes	803265	Agent - Life	6/14/2016	2/28/2023
Inactive	Hodge, Samuel Louis	854414	Agent - Health	6/14/2016	11/30/2017
Inactive	Hodge, Samuel Louis	854414	Agent - Life	6/14/2016	11/30/2017
Inactive	Jordan, Landon A	722643	Agent - Health	3/6/2012	5/10/2016
Inactive	Jordan, Landon A	722643	Agent - Life	3/6/2012	5/10/2016
Inactive	Norman, Candice Marie	889891	Agent - Health	6/14/2016	3/31/2024
Inactive	Norman, Candice Marie	889891	Agent - Life	6/14/2016	3/31/2024
Inactive	Osking, Justin Daniel	1044412	Agent - Casualty	11/12/2021	11/12/2021
Inactive	Osking, Justin Daniel	1044412	Agent - Property	11/12/2021	11/12/2021
Inactive	Paglia-Mulcahey, Jomarie	748243	Agent - Health	5/10/2016	8/23/2019
Inactive	Paglia-Mulcahey, Jomarie	748243	Agent - Life	5/10/2016	8/23/2019
Inactive	Perez, Sahed Noelia	897341	Agent - Health	6/14/2016	11/30/2017
Inactive	Perez, Sahed Noelia	897341	Agent - Life	6/14/2016	11/30/2017
Inactive	Reese, Timothy Lee	796805	Agent - Health	6/14/2016	3/31/2024
Inactive	Reese, Timothy Lee	796805	Agent - Life	6/14/2016	3/31/2024
Denied	Sanchez, Shelia Ann	822752	Agent - Health
Denied	Sanchez, Shelia Ann	822752	Agent - Life
Inactive	Shelby, Tashonna	799085	Agent - Health	6/14/2016	3/31/2021
Inactive	Simmons, Cassie Nichole	842465	Agent - Health	6/14/2016	4/30/2018
Inactive	Simmons, Cassie Nichole	842465	Agent - Life	6/14/2016	4/30/2018
Inactive	Smith, Brittany Jewell	842466	Agent - Health	6/14/2016	3/31/2021
Inactive	Smith, Brittany Jewell	842466	Agent - Life	6/14/2016	3/31/2021
Inactive	Subia, Ygnacio Lujan	726687	Agent - Health	6/14/2016	3/31/2024
Inactive	Subia, Ygnacio Lujan	726687	Agent - Life	6/14/2016	3/31/2024
Inactive	Synan, Tressie Aileene	745844	Agent - Health	6/14/2016	1/31/2021
Inactive	Synan, Tressie Aileene	745844	Agent - Life	6/14/2016	11/22/2019
Inactive	Taylor, Jocelyn Kael	818344	Agent - Health	6/14/2016	10/31/2018
Inactive	Tribble, Laci Lorraine	824083	Agent - Health	6/14/2016	6/3/2019
Inactive	Vernon, Gerod R	988899	Administrator - Not Applicable	5/25/2021	7/28/2022
Inactive	Vernon, Gerod R	988899	Agent - Health	8/22/2019	3/31/2024
Inactive	Vernon, Gerod R	988899	Agent - Life	8/22/2019	3/31/2024
Inactive	Wester, James Kevin	908074	Agent - Health	6/14/2016	4/30/2018
Denied	Wester, James Kevin	908074	Agent - Life
Inactive	Wilks, Stanley Bernard	887589	Agent - Health	6/14/2016	3/31/2024
Inactive	Wilks, Stanley Bernard	887589	Agent - Life	6/14/2016	3/31/2024
Inactive	Wimer, Tammy Susanne	794103	Agent - Health	6/14/2016	2/28/2018
Inactive	Wimer, Tammy Susanne	794103	Agent - Life	6/14/2016	2/28/2018
Inactive	Wragg, Mickey Joe	827127	Agent - Health	6/14/2016	12/31/2017
Inactive	Wragg, Mickey Joe	827127	Agent - Life	6/14/2016	12/31/2017