DEPARTMENT OF INSURANCE

Affiliations

Name	The Modern Insurance Store	DOIID	815553	NAIC NPN	17016829

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	7/25/2013	3/31/2027
Active	Non Resident	Agent	Life	7/25/2013	3/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	5/4/2022	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	4/27/2016
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	11/20/2015
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/6/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	4/27/2016
Active	Aetna Life Insurance Company	301140	Agent - Life	4/27/2016
Inactive	American Retirement Life Insurance Company	706303	Agent - Health	5/24/2016	12/21/2018
Inactive	American Retirement Life Insurance Company	706303	Agent - Life	5/24/2016	12/21/2018
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	6/9/2022
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	6/9/2022	12/19/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/9/2022
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	12/30/2021
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Health	6/3/2019	1/20/2020
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Life	6/3/2019	1/20/2020
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	6/3/2019	1/20/2020
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	6/3/2019	1/20/2020
Active	Banner Life Insurance Company	301696	Agent - Life	10/27/2015
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	8/19/2013	4/10/2015
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	8/19/2013	4/10/2015
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	10/19/2015
Active	CIGNA Health & Life Insurance Company	301783	Agent - Life	10/19/2015
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Inactive	Columbian Life Insurance Company	300810	Agent - Life	2/9/2021	1/4/2024
Inactive	CompBenefits Insurance Company	301864	Agent - Health	5/24/2023	12/12/2024
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	6/9/2022
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	8/12/2021
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	5/23/2024
Active	First Health Life & Health Insurance Company	301735	Agent - Health	4/27/2016
Active	Gerber Life Insurance Company	300529	Agent - Health	8/29/2024
Active	Gerber Life Insurance Company	300529	Agent - Life	8/29/2024
Inactive	Golden Rule Insurance Company	301943	Agent - Health	4/16/2014	10/2/2018
Inactive	Golden Rule Insurance Company	301943	Agent - Life	4/16/2014	10/2/2018
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	8/19/2013	4/10/2015
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	8/19/2013	4/10/2015
Active	Heartland National Life Insurance Company	948749	Agent - Health	12/3/2021
Active	Humana Insurance Company	301104	Agent - Health	12/6/2022
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	8/4/2023	12/12/2024
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	3/17/2014	10/29/2015
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	6/30/2023	12/26/2024
Inactive	Loyal American Life Insurance Company	301172	Agent - Life	5/19/2016	12/21/2018
Active	ManhattanLife Insurance and Annuity Company	301795	Agent - Health	3/16/2022
Active	Medco Containment Life Insurance Company	301557	Agent - Health	8/9/2024
Inactive	Medico Corp Life Insurance Company	301777	Agent - Health	6/23/2016	4/16/2018
Inactive	Medico Corp Life Insurance Company	301777	Agent - Life	6/23/2016	4/16/2018
Inactive	Medico Insurance Company	301559	Agent - Health	6/23/2016	12/26/2018
Inactive	Medico Insurance Company	301559	Agent - Life	6/23/2016	12/26/2018
Active	Royal Neighbors of America	301646	Agent - Life	7/20/2022
Active	SilverScript Insurance Company	663526	Agent - Health	9/23/2019
Active	Tier One Insurance Company	301056	Agent - Life	1/12/2024
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	11/18/2020
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	3/13/2015
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/15/2016	12/20/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	11/18/2020	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	4/14/2022	12/17/2024
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	9/10/2013	12/2/2016
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	11/18/2020
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	4/16/2024	3/1/2025
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	4/16/2024	3/1/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Farlow, John D	694826	Agent - Health	7/25/2013
Active	Farlow, John D	694826	Agent - Life	7/25/2013
Active	Selm, Anthony Joseph	711502	Agent - Health	7/28/2021
Active	Selm, Anthony Joseph	711502	Agent - Life	7/28/2021