DEPARTMENT OF INSURANCE

Name	Self Funding & Risk Management Solutions LLC	DOIID	395832	NAIC NPN	4403147

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Inactive	Resident	Administrator	Not Applicable	12/11/1998	3/31/2001

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	1900 Plantside Dr Louisville, KY 40299
Mailing	Po Box 991039 Louisville, KY 402691039