DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Fitchben, Carl F	DOIID	995222	NAIC NPN	18357061

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	5/23/2018	7/31/2024
Inactive	Non Resident	Agent	Life	5/23/2018	7/31/2024
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	10/17/2019	7/24/2020
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	3/25/2019	11/18/2019
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	3/25/2019	11/18/2019
Inactive	Continental American Insurance Company	301700	Agent - Health	2/20/2019	10/2/2019
Inactive	Continental American Insurance Company	301700	Agent - Life	2/20/2019	10/2/2019
Inactive	Reserve National Insurance Company	301073	Agent - Health	9/16/2019	8/12/2020
Inactive	Reserve National Insurance Company	301073	Agent - Life	9/16/2019	8/12/2020
Inactive	United States Fire Insurance Company	582240	Agent - Health	8/27/2018	7/31/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	10/9/2019	4/19/2022