DEPARTMENT OF INSURANCE

Affiliations

Name	Dernier, Rachel	DOIID	786139	NAIC NPN	16660670

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	7/13/2012	12/31/2018
Inactive	Non Resident	Agent	Health	7/13/2012	12/31/2018
* 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	ACE American Insurance Company	300625	Agent - Health	11/10/2017	12/31/2018
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Health	8/21/2018	2/12/2019
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	6/27/2018	9/28/2018
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	6/15/2016	12/31/2018
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	1/25/2018	10/30/2018
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	1/25/2018	10/30/2018
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/25/2015	12/13/2016
Inactive	Companion Life Insurance Company	300191	Agent - Health	11/23/2016	11/21/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/25/2015	12/13/2016
Inactive	Everest Reinsurance Company	301836	Agent - Health	12/12/2016	12/31/2018
Inactive	Federal Insurance Company	301144	Agent - Health	11/10/2017	12/31/2018
Inactive	Freedom Life Insurance Company of America	300074	Agent - Health	2/13/2013	5/18/2015
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	2/13/2013	5/18/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Health	11/22/2017	1/3/2019
Inactive	Golden Rule Insurance Company	301943	Agent - Life	11/22/2017	1/3/2019
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	12/27/2016	12/7/2018
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	12/27/2016	12/7/2018
Inactive	HCC Life Insurance Company	301827	Agent - Health	10/30/2014	4/8/2015
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	8/25/2015	12/13/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	8/25/2015	12/13/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/25/2015	12/13/2016
Inactive	Humana Insurance Company	301104	Agent - Health	8/25/2015	12/13/2016
Inactive	Humana Insurance Company	301104	Agent - Life	8/25/2015	12/13/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/25/2015	12/13/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/25/2015	12/13/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	8/25/2015	12/13/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/25/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/25/2015	10/22/2015
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	3/29/2018	9/26/2018
Inactive	Loyal American Life Insurance Company	301172	Agent - Life	3/29/2018	9/26/2018
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	11/10/2017	12/31/2018
Inactive	Pioneer American Insurance Company	301268	Agent - Life	9/27/2017	12/31/2018
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	7/20/2018	12/31/2018
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	10/6/2014	2/4/2016
Inactive	Time Insurance Company	300683	Agent - Health	2/2/2015	12/31/2018
Inactive	Time Insurance Company	300683	Agent - Life	2/2/2015	12/31/2018
Inactive	Unified Life Insurance Company	543169	Agent - Health	9/21/2016	12/28/2017
Inactive	United Teacher Associates Insurance Company	300747	Agent - Health	7/31/2013	11/25/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Source One Insurance Group, LLC	787497	Agent - Life	2/13/2013	4/4/2013
Inactive	Health Source One Insurance Group, LLC	787497	Agent - Health	2/13/2013	4/4/2013
Inactive	Homeland Healthcare, LLC	736705	Agent - Life	2/14/2013	4/4/2013
Inactive	Homeland Healthcare, LLC	736705	Agent - Health	2/14/2013	4/4/2013