DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Perez, Ray	DOIID	1015321	NAIC NPN	17260963

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/17/2018		4/30/2027
Active	Non Resident	Agent	Life	10/17/2018		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	02/15/2025	04/30/2025	03/20/2025	03/20/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	11/4/2021
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	11/4/2021
Active	Combined Insurance Company of America	301472	Agent - Health	6/18/2024
Active	Combined Insurance Company of America	301472	Agent - Life	6/18/2024
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	10/4/2022
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	10/4/2022
Active	ReliaStar Life Insurance Company	301712	Agent - Health	6/29/2023
Active	ReliaStar Life Insurance Company	301712	Agent - Life	6/29/2023
Active	Starmount Life Insurance Company	628031	Agent - Health	10/4/2022
Active	UNUM Life Insurance Company of America	300817	Agent - Health	10/4/2022
Active	UNUM Life Insurance Company of America	300817	Agent - Life	10/4/2022
Active	Unum Insurance Company	301499	Agent - Health	10/4/2022
Active	Unum Insurance Company	301499	Agent - Life	10/4/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Willis Of Illinois Inc	398318	Agent - Health
Denied	Willis Of Illinois Inc	398318	Agent - Life
Active	Willis Towers Watson Midwest, Inc	534348	Agent - Health	9/12/2022
Active	Willis Towers Watson Midwest, Inc	534348	Agent - Life	9/12/2022