DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Hart, Samuel Willaim	DOIID	919150	NAIC NPN	17577508

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	6/22/2016	3/31/2019
Inactive	Non Resident	Agent	Health	6/22/2016	3/31/2019
* 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	6/29/2016	9/9/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/29/2016	9/9/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Life	7/7/2016	9/9/2016
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	6/30/2016	7/14/2016
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	7/7/2016	9/9/2016
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	6/29/2016	7/24/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	eHealthInsurance Services Inc.	514105	Agent - Life	7/7/2016	7/12/2016
Inactive	eHealthInsurance Services Inc.	514105	Agent - Health	7/1/2016	7/12/2016