DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Beacon Retiree Benefits Group Inc	DOIID	816826	NAIC NPN	14406402

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	8/8/2013	3/31/2017
Inactive	Non Resident	Agent	Health	8/8/2013	3/31/2017
* 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	10/2/2013	11/2/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/2/2013	11/2/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/2/2013	11/2/2016
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	4/21/2015	12/7/2016
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	4/21/2015	12/7/2016
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	4/21/2015	12/7/2016
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	4/21/2015	12/7/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Burke, Joseph A	816427	Agent - Health	8/8/2013	5/24/2017
Inactive	Burke, Joseph A	816427	Agent - Life	8/8/2013	5/24/2017
Inactive	Caslin, Darcy F	816429	Agent - Health	8/8/2013	3/31/2017
Inactive	Caslin, Darcy F	816429	Agent - Life	8/8/2013	3/31/2017