DEPARTMENT OF INSURANCE
Insurer Details
NAMEMountain Life Insurance Company
DOI ID301001
FEIN #621094522
ALIEN #
State of DomicileTN
Domicile Country
Merged Into
NAIC #80020
NAIC Group #4703
Entity TypeInsurer
Admitted6/30/1995
AM Best Rating
PresidentJeff Breeze
Process AgentCT Corporation System
Date Assigned : 2/14/2018
(See address table below for process agent address)

Authorized Insurer – these insurers are authorized to do the business of insurance by holding a Kentucky Certificate of Authority. Provides insurance coverage.
Line(s) of Authority
Life
Annuity
Health
TypeAddress
Agent Licensing Address2416 Sir Barton Way Lexington, KY 40509
Annual Statement2416 Sir Barton Way Lexington, KY 40509
Catastrophe/Disaster Coordinator Address2416 Sir Barton Way Lexington, KY 40509
Claim Information Contact Address2416 Sir Barton Way Lexington, KY 40509
Company Licenses/Fee Contact Address2416 Sir Barton Way Lexington, KY 40509
Consumer Complaint2416 Sir Barton Way Lexington, KY 40509
Deposits Contact Address2416 Sir Barton Way Lexington, KY 40509
Life Form and Rate Filing2416 Sir Barton Way Lexington, KY 40509
Mailing2416 Sir Barton Way Lexington, KY 40509
Managing General Agent2416 Sir Barton Way Lexington, KY 40509
Managing General Agent2416 Sir Barton Way Lexington, KY 40509
Policyholder Information Contact Address2416 Sir Barton Way Lexington, KY 40509
Premium Tax Address2416 Sir Barton Way Lexington, KY 40509
Process Agent306 West Main Street Suite 512 Frankfort, KY 40601
Regulatory Compliance/Gvmt Relations Contact Address2416 Sir Barton Way Lexington, KY 40509
Statutory Home Office2416 Sir Barton Way Lexington, KY 40509
U.S. Legal Counsel for Aliens2416 Sir Barton Way Lexington, KY 40509
TypeNumber
Consumer Complaint - Business / Home Office(859) 367-5233
Business / Home Office(800) 888-6542
Catastrophe/Disaster Coordination Contact - Business / Home Office(859) 367-5233
Claim Information Contact - Business / Home Office(859) 367-5233
Company Licenses/Fees Contact - Business / Home Office(859) 367-5233
Deposits Contact - Business / Home Office(859) 367-5233
Local Office in Domestic/Foreign State Contact - Business / Home Office(859) 367-5233
Managing General Agent - Business / Home Office(859) 367-5233
Policyholder Information Contact - Business / Home Office(859) 367-5233
Regulatory Compliance/Gvmt Relations Contact - Business / Home Office(859) 367-5233
U.S. Legal Counsel for aliens - Business / Home Office(859) 367-5233
Annual Statement - Fax(859) 335-0307
Regulatory Compliance/Gvmt Relations Contact - Fax(859) 335-0307
Premium Tax Contact - Fax(859) 335-0307
Policyholder Information Contact - Fax(859) 335-0307
Managing General Agent - Fax(859) 335-0307
Managing General Agent - Fax(859) 335-0307
U.S. Legal Counsel for aliens - Fax(859) 335-0307
Deposits Contact - Fax(859) 335-0307
Consumer Complaint - Fax(859) 335-0307
Company Licenses/Fees Contact - Fax(859) 335-0307
Claim Information Contact - Fax(859) 335-0307
Catastrophe/Disaster Coordination Contact - Fax(859) 335-0307
Licensing - Agent Licensing Phone(859) 367-5233
Annual Statement - Annual Statement(859) 335-0307
Premium Tax Contact - Premium Tax (859) 367-5233
TypeInternet Information
Annual Statement - Business Emaildacombs@mountainlife.com
Licensing - Business Emailjebreeze@kyhomelife.com
Deposits Contact - Business Emailjebreeze@kyhomelife.com
Catastrophe/Disaster Coordination Contact - Business Emailjebreeze@kyhomelife.com
Claim Information Contact - Business Emailjebreeze@kyhomelife.com
Company Licenses/Fees Contact - Business Emailjebreeze@kyhomelife.com
Consumer Complaint - Business Emailjebreeze@kyhomelife.com
Local Office in Domestic/Foreign State Contact - Business Emailjebreeze@kyhomelife.com
Managing General Agent - Business Emailjebreeze@kyhomelife.com
Policyholder Information Contact - Business Emailjebreeze@kyhomelife.com
Premium Tax Contact - Business Emailjebreeze@kyhomelife.com
Regulatory Compliance/Gvmt Relations Contact - Business Emailjebreeze@kyhomelife.com
U.S. Legal Counsel for aliens - Business Emailjebreeze@kyhomelife.com

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