DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	National Insurance Associates DBA : EXEMPLAR INSURANCE ASSOCIATES	DOIID	1072755	NAIC NPN	19098696

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	2/2/2020		3/31/2026
Active	Non Resident	Agent	Life	2/2/2020		3/31/2026
* 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	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	4/7/2020
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/28/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	4/7/2020
Inactive	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	7/23/2021	6/14/2022
Active	SilverScript Insurance Company	663526	Agent - Health	4/7/2020
Active	Standard Life and Accident Insurance Company	301534	Agent - Health	8/3/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hawley, Tim M	607672	Agent - Health	2/2/2020
Active	Hawley, Tim M	607672	Agent - Life	2/2/2020