DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Simple Ins LLC	DOIID	827851	NAIC NPN	17022068

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	1/7/2014	3/31/2016
Inactive	Non Resident	Agent	Life	1/7/2014	3/31/2016
Withdrawn	Non Resident	Agent	Casualty
Withdrawn	Non Resident	Managing General Agent	Not Applicable
* 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	CompBenefits Dental, Inc.	591692	Agent - Health	4/9/2014	12/5/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	4/9/2014	12/5/2014
Inactive	Golden Rule Insurance Company	301943	Agent - Health	6/2/2014	4/15/2016
Inactive	Golden Rule Insurance Company	301943	Agent - Life	6/2/2014	4/15/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/9/2014	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	4/9/2014	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	4/9/2014	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/9/2014	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/9/2014	12/5/2014
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/5/2015	4/15/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Swartzbaugh, Robert F	754592	Agent - Health	1/7/2014	3/31/2016
Inactive	Swartzbaugh, Robert F	754592	Agent - Life	1/7/2014	3/31/2016