DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Forbis, Terrie Leann	DOIID	894713	NAIC NPN	17737233

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/8/2015	12/11/2017
Inactive	Non Resident	Staff Adjuster	Property & Casualty	4/13/2021	7/31/2024
* 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	Golden Rule Insurance Company	301943	Agent - Health	10/16/2015	5/17/2016
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	10/28/2015	3/10/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	10/16/2015	5/17/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/16/2015	12/11/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ttec Healthcare Solutions, Inc.	814587	Agent - Health	10/16/2015	8/12/2016