DEPARTMENT OF INSURANCE

Affiliations

Name	Klug, Thomas Mark	DOIID	816500	NAIC NPN	16892932

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	10/9/2019	5/31/2027
Active	Non Resident	Agent	Health	10/9/2019	5/31/2027
* 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	03/15/2025	05/31/2025	05/24/2025	05/24/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/27/2021
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	3/8/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/27/2021	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/27/2021	4/15/2025
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	5/8/2014	12/5/2014
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/16/2021
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	5/8/2014	12/5/2014
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	5/2/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	5/8/2014	5/2/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	5/8/2014	5/2/2016
Inactive	Humana Insurance Company	301104	Agent - Health	5/8/2014	5/2/2016
Inactive	Humana Insurance Company	301104	Agent - Life	5/8/2014	5/2/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/8/2014	5/2/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	5/8/2014	5/2/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	5/2/2016
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	5/31/2017
Inactive	Kanawha Insurance Company	300127	Agent - Health	5/8/2014	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	5/8/2014	12/5/2014
Inactive	RiverLink Health of Kentucky, Inc.	834205	Agent - Health	8/30/2015	5/4/2017
Inactive	StableView Health, Inc.	834204	Agent - Health	8/30/2015	11/25/2015
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	10/9/2019
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	10/9/2019	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/9/2019	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/9/2019

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	12/18/2014	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/18/2014	11/2/2016