DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Samuel, Taylor	DOIID	934559	NAIC NPN	18165897

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Property	11/22/2016	12/1/2017
Inactive	Resident	Agent	Health	10/31/2016	12/1/2017
Inactive	Resident	Agent	Life	10/31/2016	12/1/2017
Inactive	Resident	Agent	Casualty	11/22/2016	12/1/2017
* 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	Arcadian Health Plan, Inc.	728196	Agent - Health	11/11/2017	12/1/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	1/20/2017	12/1/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	4/10/2017	12/1/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	1/20/2017	12/1/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/10/2017	12/1/2017
Inactive	Humana Insurance Company	301104	Agent - Health	1/20/2017	12/1/2017
Inactive	Humana Insurance Company	301104	Agent - Life	1/20/2017	12/1/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	1/20/2017	12/1/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/20/2017	12/1/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	4/10/2017	12/1/2017
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/20/2017	12/8/2017
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/20/2017	12/8/2017
Inactive	West Bend Insurance Company	672974	Agent - Casualty	9/18/2017	12/1/2017
Inactive	West Bend Insurance Company	672974	Agent - Property	9/18/2017	12/1/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Assuredpartners NL, LLC	762387	Agent - Life	1/20/2017	12/1/2017
Inactive	Assuredpartners NL, LLC	762387	Agent - Health	1/20/2017	12/1/2017