DEPARTMENT OF INSURANCE

Affiliations

Name	Borella, Matthew L	DOIID	565317	NAIC NPN	7069134

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	12/10/2024	2/28/2027
Active	Non Resident	Agent	Health	8/1/2023	2/28/2027
Active	Non Resident	Agent	Life	8/1/2023	2/28/2027
* 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
Administrator	12/15/2026	02/28/2027
Agent	12/15/2026	02/28/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	1/17/2011	2/28/2011
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	1/17/2011	2/28/2011
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Health	7/25/2003	2/28/2011
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Life	7/25/2003	2/28/2011
Inactive	HM Life Insurance Company	301408	Agent - Health	2/21/2007	2/28/2011
Inactive	HM Life Insurance Company	301408	Agent - Life	2/21/2007	2/28/2011
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/7/2008	2/28/2011
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/7/2008	2/28/2011
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	12/29/2023
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	12/29/2023
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	7/22/2003	2/28/2011
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	7/22/2003	2/28/2011
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Health	7/22/2003	6/25/2008
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Life	7/22/2003	6/25/2008
Active	Starmount Life Insurance Company	628031	Agent - Health	8/4/2023
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	2/21/2007	2/28/2011
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	2/21/2007	2/28/2011
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	2/21/2007	10/1/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	2/21/2007	10/1/2008
Inactive	Trustmark Insurance Company	300317	Agent - Health	2/4/2007	2/24/2011
Inactive	Trustmark Insurance Company	300317	Agent - Life	2/4/2007	2/24/2011
Active	UNUM Life Insurance Company of America	300817	Agent - Health	8/4/2023
Active	UNUM Life Insurance Company of America	300817	Agent - Life	8/4/2023
Active	Unum Insurance Company	301499	Agent - Health	8/4/2023
Active	Unum Insurance Company	301499	Agent - Life	8/4/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Premier Work-Site Solutions, LLC	1376433	Administrator - Not Applicable	12/12/2024
Inactive	The Farmington Company	534046	Agent - Health	7/25/2003	2/28/2011
Inactive	The Farmington Company	534046	Agent - Life	7/25/2003	2/28/2011