DEPARTMENT OF INSURANCE

Affiliations

Name	Wurm Jr, Dennis Thomas	DOIID	797595	NAIC NPN	16780045

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	11/14/2012	7/31/2017
Inactive	Non Resident	Agent	Life	11/14/2012	7/31/2017
* 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	American Financial Security Life Insurance Co.	301635	Agent - Health	10/20/2015	7/31/2017
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Life	10/20/2015	7/31/2017
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/8/2015	10/8/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/8/2015	7/31/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/8/2015	7/31/2017
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	11/17/2015	7/31/2017
Inactive	Companion Life Insurance Company	300191	Agent - Health	2/1/2016	7/31/2017
Inactive	Companion Life Insurance Company	300191	Agent - Life	2/1/2016	7/31/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	11/17/2015	7/31/2017
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	8/9/2016	7/31/2017
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	8/9/2016	7/31/2017
Inactive	HCC Life Insurance Company	301827	Agent - Health	9/28/2015	5/17/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/2/2016	7/31/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/2/2016	7/31/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/23/2015	7/31/2017
Inactive	Humana Insurance Company	301104	Agent - Health	9/2/2016	7/31/2017
Inactive	Humana Insurance Company	301104	Agent - Life	9/2/2016	7/31/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/2/2016	7/31/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/2/2016	7/31/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/2/2016	7/31/2017
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	7/31/2017
Inactive	Time Insurance Company	300683	Agent - Health	11/15/2012	6/16/2015
Inactive	Time Insurance Company	300683	Agent - Life	11/15/2012	6/16/2015
Inactive	Unified Life Insurance Company	543169	Agent - Health	9/21/2015	7/31/2017

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	10/8/2015	7/31/2017
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/8/2015	7/31/2017
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	6/14/2016	7/31/2017