DEPARTMENT OF INSURANCE

Affiliations

Name	Custenborder, Patrick Raymond	DOIID	356268	NAIC NPN	1488988

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/5/1995		3/31/2027
Active	Non Resident	Agent	Life	9/5/1995		3/31/2027
Inactive	Non Resident	Agent	Health Maintenance Organization	12/30/1998	3/1/2001
* 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	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/4/2025
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/23/2021	12/19/2024
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/23/2021	11/13/2025
Inactive	Banner Life Insurance Company	301696	Agent - Life	1/30/2015	10/7/2017
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/23/2021	11/13/2025
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	7/6/2012
Inactive	Guarantee Life Insurance Company	301560	Agent - Health	9/5/1995	9/8/2000
Inactive	Guarantee Life Insurance Company	301560	Agent - Life	9/5/1995	9/8/2000
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	12/16/2009	11/23/2012
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	12/16/2009	11/23/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	7/6/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	12/30/1998	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	12/10/1998	7/6/2012
Inactive	Humana Insurance Company	301104	Agent - Life	12/10/1998	7/6/2012
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	9/8/2000	7/2/2007
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	9/8/2000	7/2/2007
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2008	7/6/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2008	7/6/2012
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	7/2/2007	3/18/2009
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	7/2/2007	3/18/2009
Active	Pan-American Life Insurance Company	301530	Agent - Health	1/6/2025
Active	Pan-American Life Insurance Company	301530	Agent - Life	1/6/2025
Inactive	Time Insurance Company	300683	Agent - Health	3/11/2008	11/23/2019
Inactive	Time Insurance Company	300683	Agent - Life	3/11/2008	11/23/2019
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	8/13/1997	12/19/2005
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	8/13/1997	12/19/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBISA Reaquisitian Corp	547026	Agent - Life	9/4/2008	11/23/2019
Inactive	CBISA Reaquisitian Corp	547026	Agent - Health	9/4/2008	11/23/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/6/2013	11/23/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/6/2013	11/23/2019
Active	Phelan Insurance Agency Inc.	512633	Agent - Life	3/6/2019
Active	Phelan Insurance Agency Inc.	512633	Agent - Health	3/6/2019