DEPARTMENT OF INSURANCE
Affiliations
NameTransitions RbgDOIID1185997NAIC NPN17104748
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth2/2/2022 3/31/2026
ActiveNon ResidentAgentLife8/28/2023 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
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202603/31/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAccendo Insurance Company300312Agent - Health2/22/202311/17/2023
ActiveAetna Health Inc. (PA)660717Agent - Health2/17/2023 
ActiveAetna Health and Life Insurance Company300523Agent - Health2/22/2023 
ActiveAetna Health of Ohio Inc.1065035Agent - Health2/17/2023 
ActiveAetna Life Insurance Company301140Agent - Health2/17/2023 
ActiveAmeritas Life Insurance Corporation300126Agent - Health2/27/2023 
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health6/28/2023 
InactiveClear Spring Health Insurance Company301686Agent - Health10/5/202212/19/2024
ActiveCompBenefits Insurance Company301864Agent - Health12/31/2024 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health2/22/2023 
ActiveDental Concern Inc. (The)301641Agent - Health4/28/2025 
InactiveDevoted Health Insurance Company of Kentucky, Inc.1306593Agent - Health10/18/20246/18/2025
ActiveHumana Insurance Company301104Agent - Health11/11/2024 
InactiveLasso Healthcare Insurance Company1022651Agent - Health6/26/202312/22/2023
ActiveMedco Containment Life Insurance Company301557Agent - Health11/19/2024 
ActiveSilverScript Insurance Company663526Agent - Health2/17/2023 
ActiveTier One Insurance Company301056Agent - Health10/10/2023 
ActiveTier One Insurance Company301056Agent - Life10/10/2023 
ActiveUnitedHealthcare Insurance Company300946Agent - Health6/28/2023 
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health6/28/2023 
ActiveWellCare Health Insurance Company of Kentucky, Inc.301478Agent - Health4/8/2022 
ActiveWellCare Prescription Insurance Inc.654329Agent - Health4/8/2022 
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveBennett, Burton E 1018360Agent - Health3/7/2025 
ActiveBennett, Burton E 1018360Agent - Life5/27/2025 
ActiveJetter, William P 995045Agent - Health6/28/2023 
ActiveJetter, William P 995045Agent - Life8/28/2023 
ActiveMiller, Jayson Andrew 678614Agent - Health10/18/2023 
ActiveMiller, Jayson Andrew 678614Agent - Life10/18/2023 
ActiveReece, Erica Whitney 1294799Agent - Health10/18/2023 
DeniedReece, Erica Whitney 1294799Agent - Life  
ActiveSmith, Cambria Mize 765584Agent - Health2/2/2022 

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