DEPARTMENT OF INSURANCE

Name	Employee Benefit Assoc Inc	DOIID	648452	NAIC NPN	9062518

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	1/29/2007		3/31/2025
Active	Resident	Agent	Life	1/29/2007		3/31/2025
Inactive	Resident	Agent	Property	2/13/2015	6/1/2023
Inactive	Resident	Agent	Casualty	2/13/2015	6/1/2023
Withdrawn	Resident	Agent	Personal Lines

*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	01/15/2025	03/31/2025

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

Address Information

Type	Address
Business / Home Office	1029 Monarch Street Suite 130Lexington, KY 40513

Phone Information

Type	Phone
Business / Home Office	(859) 422-4242