DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Hazelett Jr, Edward J	DOIID	898416	NAIC NPN	17768066

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	11/10/2015	6/30/2017
Inactive	Non Resident	Agent	Life	11/10/2015	6/30/2017
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	11/15/2016	6/30/2017
Inactive	Aetna Life Insurance Company	301140	Agent - Health	11/15/2016	6/30/2017
Inactive	Aetna Life Insurance Company	301140	Agent - Life	11/15/2016	6/30/2017
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	11/15/2016	6/30/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	11/21/2016	6/30/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Health	1/12/2016	1/31/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	1/12/2016	1/31/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/17/2016	6/30/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/17/2016	6/30/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/17/2016	6/30/2017
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	1/12/2016	1/23/2017
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	1/12/2016	1/23/2017
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	1/12/2016	1/31/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Gethealthinsurance Com Agency Inc	657389	Agent - Life	7/11/2016	6/30/2017
Inactive	Gethealthinsurance Com Agency Inc	657389	Agent - Health	7/11/2016	6/30/2017