DEPARTMENT OF INSURANCE

Affiliations

Name	Koufeldt Jr, Robert Darrell	DOIID	787101	NAIC NPN	16705555

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	7/27/2012	3/31/2015
Inactive	Non Resident	Agent	Life	7/27/2012	3/31/2015
* 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	10/9/2012	3/31/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/9/2012	3/31/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/31/2012	4/14/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/31/2012	4/14/2014
Inactive	Gerber Life Insurance Company	300529	Agent - Health	8/27/2012	3/31/2015
Inactive	Gerber Life Insurance Company	300529	Agent - Life	8/27/2012	3/31/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/25/2012	4/14/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/31/2012	4/14/2014
Inactive	Humana Insurance Company	301104	Agent - Health	8/29/2012	4/14/2014
Inactive	Humana Insurance Company	301104	Agent - Life	8/29/2012	4/14/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/31/2012	4/14/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/31/2012	4/14/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/31/2012	4/14/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/31/2012	4/14/2014
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	9/6/2012	2/6/2013
Inactive	Omaha Insurance Company	751908	Agent - Health	9/7/2012	2/6/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	9/6/2012	2/6/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	9/6/2012	2/6/2013
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	1/24/2013	12/19/2013
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	11/5/2012	12/17/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Continental Health Alliance LLC	667000	Agent - Life	8/31/2012	2/23/2015
Inactive	Continental Health Alliance LLC	667000	Agent - Health	8/31/2012	2/23/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Life	10/13/2012	3/31/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/13/2012	3/31/2015