DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ballard, Lorenzo R	DOIID	910654	NAIC NPN	17886630

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/25/2016	12/31/2018
Inactive	Non Resident	Agent	Life	3/25/2016	12/31/2018
* 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	10/12/2017	12/31/2018
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/12/2017	12/31/2018
Inactive	Aetna Life Insurance Company	301140	Agent - Life	10/12/2017	12/31/2018
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Health	10/4/2017	12/31/2018
Inactive	American General Life Insurance Company	301585	Agent - Health	9/8/2017	12/31/2018
Inactive	American General Life Insurance Company	301585	Agent - Life	9/8/2017	12/31/2018
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	10/12/2017	12/31/2018
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	3/29/2016	12/31/2018
Inactive	Omaha Insurance Company	751908	Agent - Health	3/29/2016	12/31/2018
Inactive	Unified Life Insurance Company	543169	Agent - Health	8/29/2017	12/12/2017
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	3/29/2016	12/31/2018
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	3/29/2016	12/31/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Life	4/23/2018	12/31/2018
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	4/23/2018	12/31/2018