DEPARTMENT OF INSURANCE
Affiliations
NameSample, Mandy DOIID898574NAIC NPN17774363
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveResidentAgentHealth11/19/2015 4/30/2025
ActiveResidentAgentLife11/19/2015 4/30/2025
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAmerican United Life Insurance Company300498Agent - Health1/11/20179/29/2023
InactiveAmerican United Life Insurance Company300498Agent - Life1/11/20179/29/2023
ActiveAnthem Life Insurance Company301209Agent - Health1/25/2017 
ActiveAnthem Life Insurance Company301209Agent - Life1/25/2017 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveDesignated Agent Company Inc.681257Agent - Life1/26/2017 
ActiveDesignated Agent Company Inc.681257Agent - Health1/26/2017 
InactiveKentucky Hospital Service Company of Kentucky, LLC401254Agent - Life1/25/20172/23/2018
InactiveKentucky Hospital Service Company of Kentucky, LLC401254Agent - Health1/25/20172/23/2018

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