DEPARTMENT OF INSURANCE

Affiliations

Name	Rocourt, Dominique	DOIID	792222	NAIC NPN	16789872

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	9/24/2012	10/11/2018
Inactive	Non Resident	Agent	Life	9/24/2012	10/11/2018
* 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	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	2/17/2016	6/12/2018
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/5/2012	10/11/2018
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/5/2012	10/11/2018
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Health	10/30/2015	10/11/2018
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	2/1/2014	5/28/2015
Inactive	Companion Life Insurance Company	300191	Agent - Health	3/28/2017	3/12/2018
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	4/24/2017	6/8/2018
Inactive	Federal Insurance Company	301144	Agent - Health	7/10/2017	10/11/2018
Inactive	Golden Rule Insurance Company	301943	Agent - Health	2/5/2016	9/5/2018
Inactive	Golden Rule Insurance Company	301943	Agent - Life	2/5/2016	9/5/2018
Inactive	HCC Life Insurance Company	301827	Agent - Health	7/15/2015	10/3/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	2/1/2014	5/28/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/31/2014	5/28/2015
Inactive	Humana Insurance Company	301104	Agent - Health	1/27/2014	5/28/2015
Inactive	Humana Insurance Company	301104	Agent - Life	1/27/2014	5/28/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	1/27/2014	5/28/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/27/2014	5/28/2015
Inactive	Independence American Insurance Company	524747	Agent - Health	6/26/2018	10/11/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/1/2014	5/28/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/1/2014	5/28/2015
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	3/1/2017	4/6/2018
Inactive	Unified Life Insurance Company	543169	Agent - Health	3/7/2017	12/12/2017
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	2/5/2016	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	2/5/2016	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	2/5/2016	2/14/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	10/5/2012	10/11/2018
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/5/2012	10/11/2018