DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	BREEZE FMO LLC	DOIID	1230094	NAIC NPN	20321901

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	9/16/2022		3/31/2026
Active	Non Resident	Agent	Health	9/16/2022		3/31/2026
Active	Non Resident	Agent	Casualty	9/16/2022		3/31/2026
Active	Non Resident	Agent	Property	9/16/2022		3/31/2026
* 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	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	9/19/2022
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/19/2022
Active	American National Insurance Company	301861	Agent - Life	12/1/2022
Active	CareSource Kentucky Co.	838179	Agent - Health	1/29/2024
Active	National Guardian Life Insurance Company	300596	Agent - Health	9/28/2022
Active	Philadelphia American Life Insurance Company	300178	Agent - Health	12/15/2022
Active	Philadelphia American Life Insurance Company	300178	Agent - Life	12/15/2022
Active	Tier One Insurance Company	301056	Agent - Health	1/3/2023

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Burton, Kevin Eugene	1089770	Agent - Casualty	9/16/2022
Active	Burton, Kevin Eugene	1089770	Agent - Health	9/16/2022
Active	Burton, Kevin Eugene	1089770	Agent - Life	9/16/2022
Active	Burton, Kevin Eugene	1089770	Agent - Property	9/16/2022