DEPARTMENT OF INSURANCE
Affiliations
NameThe Modern Insurance StoreDOIID815553NAIC NPN17016829
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth7/25/2013 3/31/2027
ActiveNon ResidentAgentLife7/25/2013 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
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202703/31/2027   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAccendo Insurance Company300312Agent - Health5/4/202211/17/2023
InactiveAccendo Insurance Company300312Agent - Life6/10/202012/19/2025
ActiveAetna Health Inc. (PA)660717Agent - Health4/27/2016 
ActiveAetna Health and Life Insurance Company300523Agent - Health11/20/2015 
ActiveAetna Health of Ohio Inc.1065035Agent - Health8/6/2020 
ActiveAetna Life Insurance Company301140Agent - Health4/27/2016 
ActiveAetna Life Insurance Company301140Agent - Life4/27/2016 
InactiveAmerican Retirement Life Insurance Company706303Agent - Health5/24/201612/21/2018
InactiveAmerican Retirement Life Insurance Company706303Agent - Life5/24/201612/21/2018
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health6/9/2022 
InactiveAnthem Health Plans of New Hampshire, Inc.944064Agent - Health6/9/202212/19/2024
ActiveAnthem Insurance Companies, Inc.300941Agent - Health6/9/2022 
ActiveArcadian Health Plan, Inc.728196Agent - Health12/30/2021 
InactiveBankers Fidelity Assurance Company554627Agent - Health6/3/20191/20/2020
InactiveBankers Fidelity Assurance Company554627Agent - Life6/3/20191/20/2020
InactiveBankers Fidelity Life Insurance Company300193Agent - Health6/3/20191/20/2020
InactiveBankers Fidelity Life Insurance Company300193Agent - Life6/3/20191/20/2020
ActiveBanner Life Insurance Company301696Agent - Life10/27/2015 
InactiveBerkshire Life Insurance Company of America300983Agent - Health8/19/20134/10/2015
InactiveBerkshire Life Insurance Company of America300983Agent - Life8/19/20134/10/2015
ActiveCHA HMO, Inc.300662Agent - Health12/3/2025 
ActiveCIGNA Health & Life Insurance Company301783Agent - Health10/19/2015 
ActiveCIGNA Health & Life Insurance Company301783Agent - Life10/19/2015 
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health7/20/2022 
InactiveColumbian Life Insurance Company300810Agent - Life2/9/20211/4/2024
InactiveCompBenefits Insurance Company301864Agent - Health5/24/202312/12/2024
ActiveCompcare Health Services Insurance Corporation948751Agent - Health6/9/2022 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health3/6/2018 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Life8/12/2021 
ActiveEmphesys Insurance Company300598Agent - Health10/24/2025 
ActiveFidelity & Guaranty Life Insurance Company301359Agent - Life5/23/2024 
ActiveFirst Health Life & Health Insurance Company301735Agent - Health4/27/2016 
ActiveGerber Life Insurance Company300529Agent - Health8/29/2024 
ActiveGerber Life Insurance Company300529Agent - Life8/29/2024 
InactiveGolden Rule Insurance Company301943Agent - Health4/16/201410/2/2018
InactiveGolden Rule Insurance Company301943Agent - Life4/16/201410/2/2018
InactiveGuardian Life Insurance Company of America301316Agent - Health8/19/20134/10/2015
InactiveGuardian Life Insurance Company of America301316Agent - Life8/19/20134/10/2015
ActiveHealthSpring National Health Insurance Company300235Agent - Health11/3/2025 
ActiveHeartland National Life Insurance Company948749Agent - Health12/3/2021 
ActiveHumana Insurance Company301104Agent - Health12/6/2022 
InactiveHumana Wisconsin Health Organization Insurance Corporation830687Agent - Health8/4/202312/12/2024
InactiveKentucky Health Cooperative, Inc.798780Agent - Health3/17/201410/29/2015
ActiveLoyal American Life Insurance Company301172Agent - Health1/3/2026 
InactiveLoyal American Life Insurance Company301172Agent - Life5/19/201612/21/2018
ActiveManhattanLife Insurance and Annuity Company301795Agent - Health3/16/2022 
ActiveMedco Containment Life Insurance Company301557Agent - Health8/9/2024 
InactiveMedico Corp Life Insurance Company301777Agent - Health6/23/20164/16/2018
InactiveMedico Corp Life Insurance Company301777Agent - Life6/23/20164/16/2018
InactiveMedico Insurance Company301559Agent - Health6/23/201612/26/2018
InactiveMedico Insurance Company301559Agent - Life6/23/201612/26/2018
ActiveNational Health Insurance Company300554Agent - Health1/28/2026 
ActiveNational Health Insurance Company300554Agent - Life1/28/2026 
ActiveRoyal Neighbors of America301646Agent - Life7/20/2022 
ActiveSilverScript Insurance Company663526Agent - Health9/23/2019 
ActiveTier One Insurance Company301056Agent - Life1/12/2024 
ActiveUnitedHealthcare Insurance Company300946Agent - Health11/18/2020 
ActiveUnitedHealthcare Insurance Company300946Agent - Life3/13/2015 
InactiveUnitedHealthcare Insurance Company of America301552Agent - Health9/15/201612/20/2018
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health11/18/202012/22/2022
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health4/14/202212/17/2024
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health9/10/201312/2/2016
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health11/18/2020 
ActiveWellCare Health Insurance Company of Kentucky, Inc.301478Agent - Health10/3/2025 
ActiveWellCare Prescription Insurance Inc.654329Agent - Health10/3/2025 
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveFarlow, John D 694826Agent - Health7/25/2013 
ActiveFarlow, John D 694826Agent - Life7/25/2013 
ActiveSelm, Anthony Joseph 711502Agent - Health7/28/2021 
ActiveSelm, Anthony Joseph 711502Agent - Life7/28/2021 

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