DEPARTMENT OF INSURANCE

Affiliations

Name	Green, David A	DOIID	374617	NAIC NPN	1495055

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/23/2023		2/28/2026
Active	Non Resident	Agent	Life	10/23/2023		2/28/2026
Inactive	Non Resident	Agent	Casualty	6/7/2005	2/28/2018
Inactive	Non Resident	Agent	Property	6/7/2005	2/28/2018
Inactive	Non Resident	Agent	Health Maintenance Organization	1/24/1997	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	12/15/2025	02/28/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc.	300694	Agent - Health	6/5/2007	12/31/2007
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007	10/4/2011
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/5/2007	10/4/2011
Inactive	Aetna Life Insurance Company	301140	Agent - Life	6/5/2007	10/4/2011
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	11/29/2007	10/1/2010
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	11/29/2007	10/1/2010
Inactive	Anthem Life Insurance Company	301209	Agent - Health	6/1/2004	11/2/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/1/2004	11/2/2016
Inactive	Banner Life Insurance Company	301696	Agent - Life	5/11/2006	2/28/2018
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	8/30/2013
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	6/18/2008	3/30/2018
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	6/18/2008	3/30/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	8/30/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	1/24/1997	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	8/1/1995	8/30/2013
Inactive	Humana Insurance Company	301104	Agent - Life	8/1/1995	8/30/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/26/2011	4/25/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/26/2011	4/25/2013
Active	Metropolitan Life Insurance Company	301948	Agent - Health	10/30/2023
Active	Metropolitan Life Insurance Company	301948	Agent - Life	10/30/2023
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	10/11/2007	6/5/2015
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	10/11/2007	6/5/2015
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Health	10/11/2007	6/25/2008
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Life	10/11/2007	6/25/2008
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	12/7/2005	1/30/2006
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	12/7/2005	1/30/2006

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	5/28/2004	6/23/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	5/28/2004	6/23/2008
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/29/2008	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/29/2008	11/2/2016
Denied	Maddox Ins Agency Llc	617450	Agent - Property
Denied	Maddox Ins Agency Llc	617450	Agent - Casualty