DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Miller, Shane Thomas	DOIID	827299	NAIC NPN	17100613

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	12/17/2013	8/31/2019
Inactive	Non Resident	Agent	Health	12/17/2013	8/31/2019
* 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	1/7/2014	9/8/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/7/2014	9/8/2017
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	11/2/2016	12/27/2018
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	11/2/2016	12/27/2018

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 - Health	1/7/2014	12/27/2018
Inactive	Designated Agent Company Inc.	681257	Agent - Life	1/7/2014	12/27/2018