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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	09/15/2026	11/30/2026

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