DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Green Jr, Ld	DOIID	939372	NAIC NPN	9295899

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	12/9/2016	10/23/2018
Inactive	Non Resident	Agent	Life	12/9/2016	10/23/2018
* 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	1/4/2017	10/20/2017
Inactive	Aetna Life Insurance Company	301140	Agent - Health	1/4/2017	10/20/2017
Inactive	Aetna Life Insurance Company	301140	Agent - Life	1/4/2017	12/7/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Health	12/24/2016	8/5/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/24/2016	8/5/2017
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	12/9/2016	7/27/2017
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	12/9/2016	7/27/2017
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	1/4/2017	10/20/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Health	12/27/2016	9/15/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	12/27/2016	9/15/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	6/1/2017	12/10/2018
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	12/21/2016	8/21/2017
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	12/21/2016	8/21/2017
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	12/21/2016	8/21/2017

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 - Life	12/30/2016	8/4/2017
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/30/2016	8/4/2017
Inactive	HealthMarkets Insurance Agency Inc	709727	Agent - Life	3/9/2017	11/29/2017
Inactive	HealthMarkets Insurance Agency Inc	709727	Agent - Health	3/9/2017	11/29/2017