DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gephart, Susan Toennies	DOIID	849313	NAIC NPN	16848138

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	8/25/2014	12/31/2016
Inactive	Non Resident	Agent	Health	8/25/2014	12/31/2016
* 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 - Health	9/5/2014	10/21/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/5/2014	10/21/2016
Inactive	Physicians Life Insurance Company	300924	Agent - Life	11/11/2014	5/29/2015
Inactive	Physicians Mutual Insurance Company, Inc.	301084	Agent - Health	11/11/2014	5/29/2015

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	9/5/2014	10/21/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	9/5/2014	10/21/2016