DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	National Health Ins Agency LLC	DOIID	816297	NAIC NPN	16835535

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/2/2013	4/1/2015
Inactive	Non Resident	Agent	Life	8/2/2013	4/1/2015
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/1/2013	4/1/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/1/2013	4/1/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/1/2013	4/1/2015
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	8/15/2013	4/23/2014
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	8/15/2013	4/23/2014
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/21/2013	12/5/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/21/2013	12/5/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/21/2013	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/21/2013	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/21/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/21/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/21/2013	12/5/2014
Inactive	Time Insurance Company	300683	Agent - Health	9/18/2014	12/20/2014
Inactive	Time Insurance Company	300683	Agent - Life	9/18/2014	12/20/2014

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Wallace, Tammy Loraine	799933	Agent - Health	8/2/2013	1/31/2015
Inactive	Wallace, Tammy Loraine	799933	Agent - Life	8/2/2013	1/31/2015