DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Burgess, Ajhani	DOIID	1298554	NAIC NPN	20849942

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	9/14/2023		8/31/2026
Active	Non Resident	Agent	Health	9/14/2023		8/31/2026
Active	Non Resident	Staff Adjuster	Property & Casualty	11/21/2025		8/31/2028
* 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	06/15/2026	08/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/25/2023	8/20/2024
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	1/11/2024	2/2/2024
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	1/11/2024	2/2/2024
Inactive	Golden Rule Insurance Company	301943	Agent - Health	1/11/2024	3/30/2024
Inactive	Golden Rule Insurance Company	301943	Agent - Life	1/11/2024	3/30/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Trubridge Inc	717747	Agent - Life	1/11/2024	3/30/2024
Inactive	Trubridge Inc	717747	Agent - Health	12/18/2023	4/10/2024