DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gentry, Mitchell Todd	DOIID	953824	NAIC NPN	18338443

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	5/22/2017	7/31/2023
Inactive	Resident	Agent	Health	5/22/2017	7/31/2023
AFFIDAVIT ON FILE
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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	10/12/2017	5/28/2019
Inactive	Continental General Insurance Company	300691	Agent - Health	8/9/2018	1/25/2019
Inactive	Continental General Insurance Company	300691	Agent - Life	8/9/2018	1/25/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	5/31/2017	5/28/2019
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	10/30/2017	8/26/2021
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	10/30/2017	8/26/2021
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	5/31/2017	5/28/2019
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	1/22/2019	5/28/2019
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	5/31/2017	5/28/2019
Inactive	Humana Insurance Company	301104	Agent - Health	5/31/2017	5/28/2019
Inactive	Humana Insurance Company	301104	Agent - Life	5/31/2017	5/28/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/31/2017	5/28/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	5/31/2017	5/28/2019
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	5/31/2017	5/28/2019
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	5/31/2017	5/28/2019
Inactive	Kanawha Insurance Company	300127	Agent - Health	5/31/2017	8/9/2018
Inactive	Kanawha Insurance Company	300127	Agent - Life	5/31/2017	8/9/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	11/21/2017	6/18/2019