DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Scott, Derrick D	DOIID	843088	NAIC NPN	17278168

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	6/14/2014	7/31/2016
Inactive	Non Resident	Agent	Life	6/14/2014	7/31/2016
* 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 - Life	1/23/2015	7/31/2016
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/29/2014	3/23/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/29/2014	3/23/2016
Inactive	Golden Rule Insurance Company	301943	Agent - Health	9/17/2014	8/4/2016
Inactive	Golden Rule Insurance Company	301943	Agent - Life	9/17/2014	8/4/2016
Inactive	Humana Insurance Company	301104	Agent - Health	10/29/2014	3/23/2016
Inactive	Humana Insurance Company	301104	Agent - Life	10/29/2014	3/23/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/29/2014	3/23/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/29/2014	3/23/2016
Inactive	Life Insurance Company of the Southwest	301867	Agent - Health	6/23/2014	10/23/2014
Inactive	Life Insurance Company of the Southwest	301867	Agent - Life	6/23/2014	10/23/2014
Inactive	National Health Insurance Company	300554	Agent - Health	4/16/2015	7/31/2016
Inactive	National Health Insurance Company	300554	Agent - Life	4/16/2015	7/31/2016
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	6/14/2014	9/8/2015
Inactive	Time Insurance Company	300683	Agent - Health	1/5/2015	7/31/2016
Inactive	Time Insurance Company	300683	Agent - Life	1/5/2015	7/31/2016

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 - Life	1/23/2015	7/31/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	1/23/2015	7/31/2016