DEPARTMENT OF INSURANCE

Affiliations

Name	Custom Benefit Plans Inc	DOIID	808473	NAIC NPN	2007759

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	4/21/2013	3/31/2027
Active	Non Resident	Agent	Life	4/21/2013	3/31/2027
* 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	Accendo Insurance Company	300312	Agent - Health	9/10/2021	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	9/10/2019
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	7/21/2021
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/30/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	9/10/2019
Active	American National Insurance Company	301861	Agent - Life	6/6/2020
Inactive	American Retirement Life Insurance Company	706303	Agent - Health	10/28/2018	12/21/2018
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Health	11/15/2017	7/5/2018
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	4/29/2016	7/5/2018
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	10/2/2016
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Health	2/5/2018	7/11/2024
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Life	2/5/2018	7/11/2024
Inactive	Clear Spring Health Insurance Company	301686	Agent - Health	10/10/2022	12/19/2024
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	7/21/2021
Inactive	Gateway Health Plan of Ohio, Inc.	833424	Agent - Health	11/18/2017	1/1/2019
Active	Gerber Life Insurance Company	300529	Agent - Health	6/13/2022
Active	Gerber Life Insurance Company	300529	Agent - Life	6/13/2022
Active	Golden Rule Insurance Company	301943	Agent - Health	9/10/2015
Active	Golden Rule Insurance Company	301943	Agent - Life	9/10/2015
Inactive	Lumico Life Insurance Company	300354	Agent - Life	9/12/2022	11/21/2024
Active	SilverScript Insurance Company	663526	Agent - Health	10/19/2019
Active	Tier One Insurance Company	301056	Agent - Health	10/24/2022
Active	Tier One Insurance Company	301056	Agent - Life	9/20/2022
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	9/10/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	9/10/2015	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/10/2015	2/14/2017
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	12/2/2022	2/28/2025
Inactive	WellCare Health Plans of Kentucky, Inc.	838592	Agent - Health	11/3/2021	8/30/2022
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	12/2/2022	2/28/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ballew, Odell Christopher	812419	Agent - Life	4/27/2016	5/31/2018
Active	Dinardo, Salvatore	652719	Agent - Health	4/21/2013
Active	Dinardo, Salvatore	652719	Agent - Life	4/21/2013
Active	Gossman, Joseph Martin	627495	Agent - Life	9/15/2015