DEPARTMENT OF INSURANCE

Affiliations

Name	Derebe, Birutawit	DOIID	1017654	NAIC NPN	18722889

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	11/1/2018	3/31/2024
Inactive	Non Resident	Agent	Life	11/1/2018	3/31/2024
* 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	Accendo Insurance Company	300312	Agent - Health	9/10/2021	11/17/2023
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	11/14/2018	3/31/2024
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/29/2020	3/31/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	11/14/2018	3/31/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Life	11/14/2018	3/31/2024
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/15/2022	3/31/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Health	2/28/2019	2/6/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Life	2/28/2019	2/6/2024
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/21/2022	2/19/2024
Inactive	CareSource Kentucky Co.	838179	Agent - Health	4/16/2021	4/6/2023
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	11/6/2018	3/31/2024
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	11/6/2018	3/31/2024
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/17/2021	2/6/2024
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/27/2019	12/19/2019
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	11/14/2018	3/31/2024
Inactive	Golden Rule Insurance Company	301943	Agent - Health	2/8/2019	11/7/2023
Inactive	Golden Rule Insurance Company	301943	Agent - Life	2/8/2019	11/7/2023
Inactive	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	5/2/2022	3/31/2024
Inactive	SilverScript Insurance Company	663526	Agent - Health	8/23/2019	3/31/2024
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	4/9/2019	9/23/2021
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/1/2018	2/19/2024
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	11/1/2018	12/21/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/6/2019	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	11/1/2018	12/23/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	11/1/2018	2/19/2024
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	4/14/2022	3/2/2024
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	3/8/2019	3/4/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	2/28/2019	3/31/2024
Inactive	Designated Agent Company Inc.	681257	Agent - Health	2/28/2019	3/31/2024
Inactive	HealthMarkets Insurance Agency Inc	709727	Agent - Life	1/28/2019	12/7/2023
Inactive	HealthMarkets Insurance Agency Inc	709727	Agent - Health	1/28/2019	12/7/2023