DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Bluegrassmedicare LLC	DOIID	1319345	NAIC NPN	21047305

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	1/16/2024		3/31/2026
Active	Resident	Agent	Life	1/16/2024		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	ACE Property and Casualty Insurance Company	300520	Agent - Health	6/27/2024
Active	Aetna Health Inc. (PA)	660717	Agent - Health	8/31/2024
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/31/2024
Active	Aetna Life Insurance Company	301140	Agent - Health	8/31/2024
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	2/21/2025
Active	CHA HMO, Inc.	300662	Agent - Health	6/3/2025
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	9/8/2024
Active	CompBenefits Insurance Company	301864	Agent - Health	3/4/2025
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	2/24/2025
Active	Humana Health Plan, Inc.	300142	Agent - Health	3/4/2025
Active	Humana Insurance Company	301104	Agent - Health	2/7/2025
Active	Medco Containment Life Insurance Company	301557	Agent - Health	3/24/2025
Active	SilverScript Insurance Company	663526	Agent - Health	8/31/2024
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	9/8/2024
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/8/2024
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	1/10/2025
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	1/10/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Potts, Thomas Wahl	311377	Agent - Health	1/16/2024
Active	Potts, Thomas Wahl	311377	Agent - Life	1/16/2024