DEPARTMENT OF INSURANCE

Affiliations

Name	Burgess, Stephan	DOIID	964344	NAIC NPN	18472818

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	8/18/2017		4/30/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	02/15/2027	04/30/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	12/22/2021	3/4/2023
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	8/31/2017	9/18/2024
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	8/26/2020	3/4/2023
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/16/2025
Active	Aetna Life Insurance Company	301140	Agent - Health	7/16/2025
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/15/2023
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	3/15/2023	12/19/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	3/15/2023
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	3/15/2024	9/16/2025
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/9/2025
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	3/15/2023
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	8/26/2020	3/4/2023
Active	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	8/30/2024
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	8/31/2017	9/18/2024
Active	Golden Rule Insurance Company	301943	Agent - Health	7/11/2025
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/5/2017	12/10/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	7/29/2024	9/16/2025
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/5/2017	6/8/2018
Inactive	Humana Insurance Company	301104	Agent - Health	6/9/2023	9/16/2025
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/5/2017	6/8/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/5/2017	6/8/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	3/24/2025	9/16/2025
Inactive	Lumico Life Insurance Company	300354	Agent - Health	6/25/2020	11/24/2020
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	8/25/2020	1/23/2023
Active	SilverScript Insurance Company	663526	Agent - Health	7/16/2025
Inactive	United World Life Insurance Company	300532	Agent - Health	8/25/2020	1/23/2023
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	8/25/2020	1/23/2023
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	7/9/2025
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	7/9/2025
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	8/20/2020	12/28/2021
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	1/9/2024

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	5/3/2019	12/16/2020
Inactive	Gohealth LLC	691445	Agent - Health	2/19/2024	9/5/2025
Inactive	TZ Insurance Solutions LLC	727470	Agent - Health	11/12/2018	12/5/2022