DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Montgomery, Glenn Leon	DOIID	848233	NAIC NPN	7692095

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/28/2021		7/31/2024
Inactive	Non Resident	Agent	Life	4/25/2016	7/31/2020
* 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	05/15/2024	07/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	4/29/2020	7/31/2020
Inactive	Aetna Life Insurance Company	301140	Agent - Health	4/29/2020	7/31/2020
Inactive	Aetna Life Insurance Company	301140	Agent - Life	4/29/2020	7/31/2020
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/14/2021	12/13/2022
Inactive	CMFG Life Insurance Company	300929	Agent - Health	4/18/2019	6/10/2019
Inactive	CMFG Life Insurance Company	300929	Agent - Life	4/18/2019	6/10/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Health	10/14/2021	12/13/2022
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/13/2014	12/29/2015
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/5/2014	12/29/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	11/22/2021	12/13/2022
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/13/2014	12/29/2015
Inactive	Humana Insurance Company	301104	Agent - Health	10/14/2021	12/13/2022
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/13/2014	12/29/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/14/2021	12/13/2022
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	11/22/2021	12/13/2022
Inactive	SilverScript Insurance Company	663526	Agent - Health	4/29/2020	7/31/2020
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/14/2014	9/29/2014
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/14/2014	9/29/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Extend Insurance Services, LLC	625753	Agent - Health	8/30/2017	1/31/2018
Inactive	Extend Insurance Services, LLC	625753	Agent - Life	8/30/2017	1/31/2018
Inactive	Optavise, LLC	671337	Agent - Health	10/8/2018	1/15/2019
Inactive	Optavise, LLC	671337	Agent - Life	10/8/2018	1/15/2019