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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2027	03/31/2027

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
Inactive	Accendo Insurance Company	300312	Agent - Life	6/10/2020	12/19/2025
Active	Aetna Health Inc. (PA)	660717	Agent - Health	9/10/2019
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	7/21/2021	12/19/2025
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
Inactive	Gossman, Joseph Martin	627495	Agent - Life	9/15/2015	2/18/2026