DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Corn, Kevin	DOIID	890913	NAIC NPN	10380383

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	7/8/2016	11/30/2020
Inactive	Non Resident	Agent	Health	9/11/2015	11/30/2020
Inactive	Non Resident	Agent	Life	9/11/2015	11/30/2020
Inactive	Non Resident	Agent	Property	7/8/2016	11/30/2020
* 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	American Heritage Life Insurance Company	300272	Agent - Health	9/27/2015	11/30/2020
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	9/27/2015	11/30/2020
Inactive	Continental American Insurance Company	301700	Agent - Health	9/16/2015	12/30/2020
Inactive	Continental American Insurance Company	301700	Agent - Life	9/16/2015	12/30/2020
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	2/10/2016	11/30/2020
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	2/10/2016	11/30/2020
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	6/21/2016	11/30/2020
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	6/21/2016	11/30/2020
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	3/30/2016	12/18/2020
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	3/30/2016	12/18/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	6/21/2016	11/30/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	6/21/2016	11/30/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mercer Health & Benefits Administration Llc	656414	Agent - Health	1/15/2019	11/30/2020
Inactive	Mercer Health & Benefits Administration Llc	656414	Agent - Life	1/15/2019	11/30/2020
Denied	Mercer Health & Benefits Administration Llc	656414	Agent - Property
Denied	Mercer Health & Benefits Administration Llc	656414	Agent - Casualty