DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Employee Benefits International Inc	DOIID	798489	NAIC NPN	9705898

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	11/28/2012	3/31/2018
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/7/2013	3/31/2018
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	8/14/2015	3/31/2018
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/3/2015	11/17/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/24/2013	11/17/2016
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	11/25/2013	3/31/2018
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/14/2014	11/17/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/9/2014	11/17/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/24/2013	11/17/2016
Inactive	Humana Insurance Company	301104	Agent - Health	10/24/2013	11/17/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/9/2014	11/17/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/14/2014	11/17/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/24/2013	10/22/2015

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dustin, James M	740219	Agent - Health	11/28/2012	3/31/2018