DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Insurance Benefits For Organized Workers	DOIID	850268	NAIC NPN	17359246

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	9/23/2020		3/31/2026
Active	Resident	Agent	Life	9/23/2020		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
Active	Combined Insurance Company of America	301472	Agent - Health	10/17/2023
Active	Combined Insurance Company of America	301472	Agent - Life	10/17/2023
Active	Metropolitan Life Insurance Company	301948	Agent - Health	12/14/2022
Active	Metropolitan Life Insurance Company	301948	Agent - Life	12/14/2022
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/31/2014	3/31/2020
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/31/2014	3/31/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	10/31/2014	3/31/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	10/31/2014	3/31/2020
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/6/2014	12/2/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	11/6/2014	12/2/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	11/6/2014	12/2/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	11/6/2014	12/2/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Manning, Roberta Jo	515423	Agent - Health	9/23/2020
Active	Manning, Roberta Jo	515423	Agent - Life	9/23/2020