DEPARTMENT OF INSURANCE

Affiliations

Name	Pancham, Kurt	DOIID	1069081	NAIC NPN	18974388

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	5/27/2022	11/30/2023
Inactive	Non Resident	Agent	Health	5/27/2022	11/30/2023
* 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	AXIS Insurance Company	301290	Agent - Health	7/20/2020	11/30/2021
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	6/9/2022	9/10/2022
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	6/9/2022	9/10/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/9/2022	9/10/2022
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	5/27/2022	7/19/2022
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	5/27/2022	7/19/2022
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	5/27/2022	7/19/2022
Inactive	Aspen American Insurance Company	301513	Agent - Health	7/16/2020	12/1/2020
Inactive	CareSource Kentucky Co.	838179	Agent - Health	5/23/2023	12/20/2023
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	7/19/2021	11/30/2021
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	7/19/2021	11/30/2021
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	5/27/2022	7/19/2022
Inactive	Federal Insurance Company	301144	Agent - Health	1/3/2020	11/30/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Health	10/30/2020	12/2/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Life	10/30/2020	12/2/2021
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	10/28/2020	11/30/2021
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Health	12/30/2019	1/16/2020
Inactive	Northwestern Mutual Life Insurance Company	300931	Agent - Life	12/30/2019	1/16/2020
Inactive	SilverScript Insurance Company	663526	Agent - Health	6/9/2022	9/10/2022
Inactive	Southern Guaranty Insurance Company	969411	Agent - Health	2/11/2021	10/1/2021
Inactive	Unified Life Insurance Company	543169	Agent - Health	4/7/2021	6/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	8/12/2020	11/30/2021