DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Prospective Risk Management LLC	DOIID	831956	NAIC NPN	17147142

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	1/21/2014		3/31/2026
Active	Non Resident	Agent	Health	1/21/2014		3/31/2026
* 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	Humana Health Plan, Inc.	300142	Agent - Health	7/18/2014	5/2/2017
Inactive	Humana Insurance Company	301104	Agent - Health	7/18/2014	12/8/2015
Inactive	Humana Insurance Company	301104	Agent - Life	7/18/2014	12/8/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	7/18/2014	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	7/18/2014	10/22/2015
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/29/2016	12/17/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	9/29/2016	12/17/2024
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/29/2016	12/17/2024
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	4/18/2022	12/17/2024

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Cape, Julie	915182	Agent - Health	5/15/2020
Active	Cape, Julie	915182	Agent - Life	5/15/2020
Active	Foster, T Eric	701444	Agent - Health	5/15/2020
Denied	Foster, T Eric	701444	Agent - Life
Inactive	Myers, William P	506339	Agent - Health	5/23/2016	5/24/2016
Inactive	Myers, William P	506339	Agent - Life	5/23/2016	5/24/2016
Inactive	Obanion, Jacqualine Kay	805611	Agent - Health	5/26/2016	5/4/2020
Inactive	Obanion, Jacqualine Kay	805611	Agent - Life	5/26/2016	5/4/2020