DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Laurich-Malison, Jill A.	DOIID	348896	NAIC NPN	3315767

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health Maintenance Organization	6/24/1998	3/1/2001
Inactive	Resident	Agent	Life	2/6/1996	11/30/2020
Inactive	Resident	Agent	Health	2/6/1996	11/30/2020
AFFIDAVIT ON FILE
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Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/1/2001	10/16/2003
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	6/24/1998	3/1/2001
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/24/1998	10/16/2003
Inactive	Anthem Life Insurance Company	301209	Agent - Health	2/6/1996	10/16/2003
Inactive	Anthem Life Insurance Company	301209	Agent - Life	2/6/1996	10/16/2003
Inactive	Dearborn Life Insurance Company	300401	Agent - Health	12/31/2004	1/19/2005
Inactive	Dearborn Life Insurance Company	300401	Agent - Life	12/31/2004	1/19/2005
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	7/28/1998	3/3/2004
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	7/28/1998	3/3/2004
Inactive	Medical Life Insurance Company	300693	Agent - Health	7/9/1998	12/31/2004
Inactive	Medical Life Insurance Company	300693	Agent - Life	7/9/1998	12/31/2004
Inactive	Reassure America Life Insurance Company	301902	Agent - Health	5/5/1998	1/3/2003
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	5/5/1998	1/3/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	3/10/1998	2/28/2003
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	3/10/1998	2/28/2003