DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Insurance Product Development Group, LC	DOIID	585528	NAIC NPN	8013377

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	4/26/2004		3/31/2026
Active	Non Resident	Agent	Health	4/26/2004		3/31/2026
* 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	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Accendo Insurance Company	300312	Agent - Life	7/29/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	9/24/2019
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	7/29/2020
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/24/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	2/19/2020
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	11/15/2022
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	1/3/2024
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018
Active	Coventry Health and Life Insurance Company	301771	Agent - Health	1/24/2011
Active	EquiTrust Life Insurance Company	502870	Agent - Life	4/13/2009
Active	First Health Life & Health Insurance Company	301735	Agent - Health	1/24/2011
Active	Healthspring Healthcare of Colorado, Inc.	1098153	Agent - Health	11/15/2022
Active	Healthspring Healthcare of Colorado, Inc.	1098153	Agent - Life	11/15/2022
Active	Sierra Health and Life Insurance Company Inc.	300357	Agent - Health	11/12/2024
Active	SilverScript Insurance Company	663526	Agent - Health	1/9/2020
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	1/3/2024
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	3/13/2022	12/22/2022
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	1/3/2024
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	3/8/2019	5/13/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Graham, Mark Burnside	638756	Agent - Health	4/13/2018	6/17/2022
Inactive	Graham, Mark Burnside	638756	Agent - Life	4/13/2018	6/17/2022
Inactive	Graham, Mark Burnside	638756	Agent - Life	4/13/2018	6/17/2022
Active	Graham, Matthew B	640480	Agent - Health	6/17/2022
Active	Graham, Matthew B	640480	Agent - Life	6/17/2022
Inactive	North, Timothy Owen	514133	Agent - Health	4/26/2004	4/13/2018
Inactive	North, Timothy Owen	514133	Agent - Life	4/26/2004	4/13/2018