DEPARTMENT OF INSURANCE

Affiliations

Name	Klemin, John R	DOIID	812275	NAIC NPN	9369819

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	6/12/2013	12/31/2025
Active	Non Resident	Agent	Health	6/12/2013	12/31/2025
* 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
Active	Aetna Health Inc. (PA)	660717	Agent - Health	3/5/2014
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/6/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	3/5/2014
Active	Aetna Life Insurance Company	301140	Agent - Life	3/5/2014
Active	American Financial Security Life Insurance Co.	301635	Agent - Health	11/18/2019
Inactive	American General Life Insurance Company	301585	Agent - Health	8/11/2013	1/23/2022
Inactive	American General Life Insurance Company	301585	Agent - Life	8/11/2013	1/23/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Health	4/17/2014	12/10/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/17/2014	12/10/2020
Inactive	Assurity Life Insurance Company	301099	Agent - Health	7/6/2014	12/20/2018
Inactive	Assurity Life Insurance Company	301099	Agent - Life	7/6/2014	12/20/2018
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	3/26/2023	7/14/2023
Active	CareSource Kentucky Co.	838179	Agent - Health	11/2/2022
Inactive	Catlin Insurance Company, Inc.	300979	Agent - Health	3/30/2015	11/19/2018
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/10/2013	3/14/2019
Active	Dental Concern Inc. (The)	301641	Agent - Health	7/10/2013
Inactive	Federal Insurance Company	301144	Agent - Health	7/17/2017	11/18/2020
Active	Golden Rule Insurance Company	301943	Agent - Health	8/2/2013
Active	Golden Rule Insurance Company	301943	Agent - Life	8/2/2013
Inactive	HCC Life Insurance Company	301827	Agent - Health	10/19/2016	6/12/2017
Active	Humana Health Plan, Inc.	300142	Agent - Health	7/10/2013
Active	Humana Insurance Company	301104	Agent - Health	12/11/2020
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	7/10/2013
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	7/10/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	7/10/2013	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	7/10/2013	10/22/2015
Active	SilverScript Insurance Company	663526	Agent - Health	7/21/2019
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	4/7/2017	12/26/2018
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	4/7/2017	12/26/2018
Inactive	Time Insurance Company	300683	Agent - Health	10/30/2013	11/22/2019
Inactive	Time Insurance Company	300683	Agent - Life	10/30/2013	11/22/2019
Inactive	Unified Life Insurance Company	543169	Agent - Health	8/10/2015	12/12/2017
Active	United States Fire Insurance Company	582240	Agent - Health	8/18/2014
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/2/2021	7/14/2023
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	11/2/2021	12/22/2022
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/12/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/12/2015	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	11/2/2021	12/23/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	11/2/2021	7/14/2023

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	4/17/2014	12/11/2020
Inactive	Designated Agent Company Inc.	681257	Agent - Health	4/17/2014	12/11/2020
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	1/2/2020	4/20/2022
Active	Pacific Benefits Group NW LLC	650001	Agent - Life	12/3/2013
Active	Pacific Benefits Group NW LLC	650001	Agent - Health	12/3/2013