DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Mt&M Group, LLC	DOIID	1118977	NAIC NPN	18136678

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	2/1/2021		3/31/2027
Active	Non Resident	Agent	Life	2/1/2021		3/31/2027
* 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
Active	Aetna Health Inc. (PA)	660717	Agent - Health	12/8/2021
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	12/8/2021
Active	Aetna Life Insurance Company	301140	Agent - Health	12/8/2021
Active	Colonial Life and Accident Insurance Company	300846	Agent - Health	2/5/2021
Active	Colonial Life and Accident Insurance Company	300846	Agent - Life	2/5/2021
Active	SilverScript Insurance Company	663526	Agent - Health	12/8/2021
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	4/6/2022	5/30/2023
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	4/6/2022	5/31/2023

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Terry, Charles Floyd	701303	Agent - Health	2/1/2021
Active	Terry, Charles Floyd	701303	Agent - Life	2/1/2021