DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Philip Ray	DOIID	925024	NAIC NPN	16914053

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/17/2016	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	12/22/2016	12/31/2018
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	4/5/2017	12/22/2017
Inactive	Aetna Life Insurance Company	301140	Agent - Health	12/22/2016	12/31/2018
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/1/2016	12/20/2017
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	4/5/2017	12/22/2017
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	12/22/2016	12/31/2018
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	2/6/2017	12/31/2018
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/29/2016	12/19/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/29/2016	12/19/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/29/2016	12/19/2017
Inactive	Humana Insurance Company	301104	Agent - Health	9/29/2016	12/19/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/29/2016	12/19/2017
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	12/19/2017
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	10/2/2017	1/30/2018
Inactive	Sierra Health and Life Insurance Company Inc.	300357	Agent - Health	8/17/2016	9/13/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/19/2016	12/18/2017
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/27/2016	12/18/2017
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/17/2016	9/13/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/19/2016	12/18/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/1/2016	12/21/2017