DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lane, Richard A	DOIID	896181	NAIC NPN	1083216

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	9/10/2018	2/28/2021
Inactive	Non Resident	Agent	Health	9/10/2018	2/28/2021
* 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 Financial Security Life Insurance Co.	301635	Agent - Health	10/21/2016	2/28/2017
Inactive	LifeShield National Insurance Company	737111	Agent - Life	10/21/2016	2/28/2017
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/19/2018	2/28/2021
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/19/2018	2/28/2021
Inactive	Starmount Life Insurance Company	628031	Agent - Health	7/19/2019	2/28/2021
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	10/19/2018	2/28/2021
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	10/19/2018	2/28/2021
Inactive	Unified Life Insurance Company	543169	Agent - Health	5/19/2016	4/25/2017
Inactive	Unum Insurance Company	301499	Agent - Health	7/19/2019	2/28/2021
Inactive	Unum Insurance Company	301499	Agent - Life	7/19/2019	2/28/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Optavise, LLC	671337	Agent - Life	10/19/2018	2/28/2021
Inactive	Optavise, LLC	671337	Agent - Health	10/19/2018	2/28/2021