DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Green, Charles Edward	DOIID	822973	NAIC NPN	17040116

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	6/12/2024		11/30/2026
Inactive	Non Resident	Agent	Life	10/3/2013	11/30/2014
* 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 Life Insurance Company	301209	Agent - Health	11/13/2013	11/30/2014
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/13/2013	11/30/2014
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	1/30/2014	11/30/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	1/30/2014	11/30/2014
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	10/13/2013	11/30/2014
Inactive	Golden Rule Insurance Company	301943	Agent - Health	10/23/2013	11/30/2014
Inactive	Golden Rule Insurance Company	301943	Agent - Life	10/23/2013	11/30/2014
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	11/30/2014
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/16/2013	11/30/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/16/2013	11/30/2014
Inactive	Humana Insurance Company	301104	Agent - Health	10/16/2013	11/30/2014
Inactive	Humana Insurance Company	301104	Agent - Life	10/16/2013	11/30/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/16/2013	11/30/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/16/2013	11/30/2014
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	11/30/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/30/2013	11/30/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/30/2013	11/30/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ae Insurance, LLC	812048	Agent - Health	10/28/2013	11/30/2014
Inactive	Ae Insurance, LLC	812048	Agent - Life	10/28/2013	11/30/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/13/2013	11/30/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/13/2013	11/30/2014