DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Forrest, Karen Roby	DOIID	546819	NAIC NPN	7224754

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	5/24/2002	5/31/2004
Inactive	Resident	Agent	Life	5/24/2002	5/31/2004
Inactive	Resident	Agent	Property	4/23/2002	5/31/2004
Inactive	Resident	Agent	Casualty	4/19/2002	5/31/2004
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/5/2002	5/31/2004
Inactive	Humana Insurance Company	301104	Agent - Health	11/7/2002	5/31/2004
Inactive	Humana Insurance Company	301104	Agent - Life	11/7/2002	5/31/2004
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	1/29/2004	5/31/2004
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/29/2004	5/31/2004
Inactive	Principal Life Insurance Company	300129	Agent - Health	5/13/2003	5/31/2004
Inactive	Principal Life Insurance Company	300129	Agent - Life	5/13/2003	5/31/2004
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	4/19/2002	5/5/2003
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	4/23/2002	5/5/2003
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	5/24/2002	5/31/2004
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	5/24/2002	5/31/2004
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/30/2002	5/31/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Barrett Roby Mucci Inc.	400105	Agent - Casualty	2/26/2003	5/5/2003
Inactive	Barrett Roby Mucci Inc.	400105	Agent - Property	2/26/2003	5/5/2003
Inactive	Barrett Roby Mucci Inc.	400105	Agent - Health	2/26/2003	11/26/2003
Inactive	Barrett Roby Mucci Inc.	400105	Agent - Life	2/26/2003	11/26/2003