DEPARTMENT OF INSURANCE

Affiliations

Name	Ryburn, Fred A	DOIID	308796	NAIC NPN	7159569

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	9/12/2013		6/30/2027
Active	Resident	Agent	Variable Life and Variable Annuities	9/12/2013		6/30/2027
Active	Resident	Agent	Life	9/12/2013		6/30/2027
Active	Resident	Agent	Casualty	9/12/2013		6/30/2027
Active	Resident	Agent	Property	9/12/2013		6/30/2027
Inactive	Resident	Agent	Health Maintenance Organization	5/22/2000	3/1/2001
Inactive	Resident	Agent	General Lines	10/10/1985	8/15/2000
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2025	06/30/2025	05/13/2025	05/13/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Health	9/9/2023	4/4/2025
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	1/22/2003	5/7/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	1/22/2003	5/7/2007
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	1/22/2003	5/7/2007
Active	American Family Home Insurance Company	301817	Agent - Casualty	12/17/2024
Active	American Family Home Insurance Company	301817	Agent - Property	12/17/2024
Active	American General Life Insurance Company	301585	Agent - Health	11/8/2022
Active	American General Life Insurance Company	301585	Agent - Life	11/8/2022
Active	American General Life Insurance Company	301585	Agent - Variable Life and Variable Annuities	11/8/2022
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	10/2/2024
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	10/2/2024
Active	American National General Insurance Company	301944	Agent - Casualty	9/20/2013
Inactive	American National General Insurance Company	301944	Agent - General Lines	10/10/1985	8/15/2000
Active	American National General Insurance Company	301944	Agent - Property	9/20/2013
Active	American National Insurance Company	301861	Agent - Health	9/12/2013
Active	American National Insurance Company	301861	Agent - Life	9/12/2013
Inactive	American National Insurance Company	301861	Agent - Variable Life and Variable Annuities	6/7/2001	5/6/2008
Inactive	American National Life Insurance Company of Texas	300912	Agent - Life	9/24/1991	1/18/2002
Active	American National Property and Casualty Company	300392	Agent - Casualty	9/20/2013
Inactive	American National Property and Casualty Company	300392	Agent - General Lines	10/10/1985	8/15/2000
Active	American National Property and Casualty Company	300392	Agent - Property	9/20/2013
Active	Banner Life Insurance Company	301696	Agent - Life	9/4/2024
Active	Bristol West Insurance Company	301655	Agent - Casualty	12/15/2021
Active	Bristol West Insurance Company	301655	Agent - Property	12/15/2021
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	6/30/1992	4/12/1999
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	6/30/1992	4/12/1999
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/3/2014
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - General Lines	3/13/1997	8/15/2000
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/3/2014
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	9/29/2015	5/11/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	9/29/2015	5/11/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	9/29/2015	5/11/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - General Lines	3/13/1997	8/15/2000
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	9/29/2015	5/11/2018
Inactive	Genworth Life Insurance Company	300623	Agent - Health	5/10/2013	7/1/2013
Inactive	Genworth Life Insurance Company	300623	Agent - Life	5/10/2013	7/1/2013
Inactive	Gerber Life Insurance Company	300529	Agent - Health	1/17/2017	8/13/2021
Active	Gerber Life Insurance Company	300529	Agent - Life	1/17/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Health	2/8/2016	10/26/2017
Inactive	Golden Rule Insurance Company	301943	Agent - Life	2/8/2016	10/26/2017
Inactive	Humana Insurance Company	301104	Agent - Health	9/2/1999	9/13/2002
Inactive	Humana Insurance Company	301104	Agent - Life	9/2/1999	9/13/2002
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	2/12/2003	12/15/2003
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	2/12/2003	12/15/2003
Inactive	John Alden Life Insurance Company	300573	Agent - Health	3/13/2013	7/16/2013
Inactive	John Alden Life Insurance Company	300573	Agent - Life	3/13/2013	7/16/2013
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	7/10/2003	6/7/2008
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	7/10/2003	6/7/2008
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	5/28/2010	4/18/2012
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	5/28/2010	4/18/2012
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	8/11/1998	8/24/2000
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	8/11/1998	8/24/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	8/10/1998	8/24/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	8/10/1998	8/24/2000
Inactive	Pruco Life Insurance Company	300954	Agent - Health	9/4/2008	7/1/2013
Inactive	Pruco Life Insurance Company	300954	Agent - Life	9/4/2008	7/1/2013
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	4/17/1998	1/4/2008
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	4/17/1998	1/4/2008
Inactive	Time Insurance Company	300683	Agent - Health	12/4/2013	9/25/2016
Inactive	Time Insurance Company	300683	Agent - Life	12/4/2013	9/25/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	2/8/2016	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	2/8/2016	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	2/8/2016	2/14/2017
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	5/22/2000	3/1/2001
Inactive	West Coast Life Insurance Company	301607	Agent - Health	8/19/2002	12/20/2004
Inactive	West Coast Life Insurance Company	301607	Agent - Life	8/19/2002	12/20/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Inactive	Ryburn Insurance Agency Inc.	398301	Agent - Life	7/2/1997	3/31/2009
Inactive	Ryburn Insurance Agency Inc.	398301	Agent - Health	7/2/1997	3/31/2009
Inactive	Ryburn Insurance Agency Inc.	398301	Agent - Health Maintenance Organization	5/22/2000	3/1/2001
Inactive	Ryburn Insurance Agency Inc.	398301	Agent - Property	5/9/2003	3/31/2009
Inactive	Ryburn Insurance Agency Inc.	398301	Agent - Casualty	5/9/2003	3/31/2009