DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bates, Ashley D	DOIID	851585	NAIC NPN	17367447

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	11/6/2018		8/31/2024
Active	Resident	Agent	Health	11/6/2018		8/31/2024
* 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	06/15/2024	08/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American United Life Insurance Company	300498	Agent - Health	6/18/2023
Active	American United Life Insurance Company	300498	Agent - Life	6/18/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/10/2014	8/31/2018
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/10/2014	8/31/2018
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	6/9/2015	10/29/2015
Active	State Life Insurance Company	301497	Agent - Health	6/18/2023
Active	State Life Insurance Company	301497	Agent - Life	6/18/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	2/17/2015	8/31/2018
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/10/2014	8/31/2018
Inactive	Designated Agent Company Inc.	681257	Agent - Life	11/10/2014	8/31/2018
Denied	Hollandstivers Employer Solutions LLC	1073922	Agent - Health
Denied	Hollandstivers Employer Solutions LLC	1073922	Agent - Life
Inactive	Planchoice Inc.	400482	Agent - Health	2/25/2015	8/31/2018
Inactive	Planchoice Inc.	400482	Agent - Life	2/25/2015	8/31/2018
Denied	Samsil & Holland, LLC	510802	Agent - Health
Denied	Samsil & Holland, LLC	510802	Agent - Life