DEPARTMENT OF INSURANCE
Affiliations
NameMSIS, INCDOIID594764NAIC NPN5781655
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife9/22/2004 3/31/2026
ActiveNon ResidentAgentHealth9/22/2004 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
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202603/31/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveACE Property and Casualty Insurance Company300520Agent - Health8/5/20224/7/2025
ActiveAccendo Insurance Company300312Agent - Health7/25/2022 
ActiveAccendo Insurance Company300312Agent - Life6/10/2020 
ActiveAetna Health Inc. (PA)660717Agent - Health3/3/2016 
ActiveAetna Health and Life Insurance Company300523Agent - Health11/2/2015 
ActiveAetna Health of Ohio Inc.1065035Agent - Health7/24/2020 
ActiveAetna Life Insurance Company301140Agent - Health3/3/2016 
ActiveAetna Life Insurance Company301140Agent - Life3/3/2016 
InactiveAmerican Continental Insurance Company643130Agent - Health5/19/20086/6/2016
InactiveAmerican Continental Insurance Company643130Agent - Life5/19/200812/6/2021
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Health9/26/201211/20/2013
InactiveAmerican National Life Insurance Company of Texas300912Agent - Health8/2/20182/21/2022
InactiveAmerican National Life Insurance Company of Texas300912Agent - Life7/28/200611/22/2010
InactiveAmerican Pioneer Life Insurance Company301782Agent - Health10/26/20049/13/2012
InactiveAmerican Pioneer Life Insurance Company301782Agent - Life10/26/20049/13/2012
InactiveAmerican Retirement Life Insurance Company706303Agent - Health8/5/201312/22/2020
InactiveAmerican Retirement Life Insurance Company706303Agent - Life8/5/201312/22/2020
InactiveAmerico Financial Life and Annuity Insurance Company300869Agent - Life7/3/202412/26/2024
ActiveAmeritas Life Insurance Corporation300126Agent - Health12/5/2021 
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health6/30/2008 
InactiveAnthem Health Plans of New Hampshire, Inc.944064Agent - Health11/1/202212/19/2024
ActiveAnthem Insurance Companies, Inc.300941Agent - Health6/12/2021 
InactiveAnthem Life Insurance Company301209Agent - Health6/30/20084/15/2025
InactiveAnthem Life Insurance Company301209Agent - Life6/30/20084/15/2025
ActiveArcadian Health Plan, Inc.728196Agent - Health10/18/2017 
ActiveCIGNA Health & Life Insurance Company301783Agent - Health10/2/2016 
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health7/20/2022 
InactiveCentral States Indemnity Company of Omaha300285Agent - Health8/28/20138/13/2018
InactiveChesapeake Life Insurance Company (The)301017Agent - Health4/11/20191/6/2025
InactiveChesapeake Life Insurance Company (The)301017Agent - Life4/11/20191/6/2025
InactiveCitizens Security Life Insurance Company301257Agent - Health9/22/200610/7/2010
InactiveCitizens Security Life Insurance Company301257Agent - Life9/22/200610/7/2010
InactiveClear Spring Health Insurance Company301686Agent - Health10/5/202212/19/2024
InactiveCompBenefits Dental, Inc.591692Agent - Health12/19/20116/15/2018
ActiveCompBenefits Insurance Company301864Agent - Health9/3/2020 
ActiveCompcare Health Services Insurance Corporation948751Agent - Health9/25/2021 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health3/6/2018 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Life7/25/2022 
ActiveCoventry Health and Life Insurance Company301771Agent - Health4/23/2010 
InactiveDental Concern Inc. (The)301641Agent - Health12/19/201112/10/2018
InactiveElips Life Insurance Company301087Agent - Health8/23/20231/23/2025
InactiveEncova Life Insurance Company301818Agent - Life5/23/20071/1/2024
InactiveEssence Healthcare, Inc.657425Agent - Health10/7/202212/24/2024
InactiveEverest Reinsurance Company301836Agent - Health7/6/20184/7/2020
InactiveEverly Life Insurance Company561641Agent - Life12/17/201311/5/2014
ActiveFirst Health Life & Health Insurance Company301735Agent - Health12/8/2008 
InactiveForethought Life Insurance Company301407Agent - Health1/5/201112/20/2016
InactiveForethought Life Insurance Company301407Agent - Life1/5/201112/20/2016
InactiveGateway Health Plan of Ohio, Inc.833424Agent - Health11/18/20171/1/2019
InactiveGenworth Life Insurance Company300623Agent - Health8/17/200612/14/2016
InactiveGenworth Life Insurance Company300623Agent - Life8/17/200612/14/2016
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health8/17/200612/14/2016
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life8/17/200612/14/2016
ActiveGerber Life Insurance Company300529Agent - Health7/30/2015 
ActiveGerber Life Insurance Company300529Agent - Life7/30/2015 
ActiveGlobe Life and Accident Insurance Company300639Agent - Health9/24/2021 
ActiveGlobe Life and Accident Insurance Company300639Agent - Life9/24/2021 
InactiveGovernment Personnel Mutual Life Insurance Company301862Agent - Health6/3/201012/26/2012
InactiveGovernment Personnel Mutual Life Insurance Company301862Agent - Life6/3/201012/26/2012
ActiveGuarantee Trust Life Insurance Company301043Agent - Health2/1/2007 
ActiveGuarantee Trust Life Insurance Company301043Agent - Life2/1/2007 
ActiveGuaranty Income Life Insurance Company552451Agent - Health3/16/2023 
ActiveGuaranty Income Life Insurance Company552451Agent - Life3/16/2023 
ActiveHealthSpring Life and Health Insurance Company, Inc.684899Agent - Health12/1/2024 
ActiveHealthSpring National Health Insurance Company300235Agent - Health12/7/2023 
ActiveHealthspring Healthcare of Colorado, Inc.1098153Agent - Health12/1/2024 
ActiveHeartland National Life Insurance Company948749Agent - Health8/18/2020 
InactiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health6/18/201512/12/2024
ActiveHumana Health Plan of Ohio Inc.301565Agent - Health10/23/2019 
InactiveHumana Health Plan, Inc.300142Agent - Health12/19/201112/10/2018
ActiveHumana Insurance Company301104Agent - Health12/19/2011 
ActiveHumana Insurance Company301104Agent - Life12/19/2011 
InactiveHumana Insurance Company of Kentucky300826Agent - Health12/19/20116/15/2018
InactiveHumana Insurance Company of Kentucky300826Agent - Life12/19/20116/15/2018
ActiveHumana Medical Plan, Inc.801568Agent - Health4/6/2021 
ActiveHumana Wisconsin Health Organization Insurance Corporation830687Agent - Health11/19/2019 
InactiveKanawha Insurance Company300127Agent - Health12/19/20114/25/2013
InactiveKanawha Insurance Company300127Agent - Life12/19/20114/25/2013
InactiveLasso Healthcare Insurance Company1022651Agent - Health8/22/20196/3/2025
ActiveLoyal American Life Insurance Company301172Agent - Health2/7/2024 
InactiveLumico Life Insurance Company300354Agent - Life2/1/202111/20/2024
InactiveManhattan Life Insurance Company300880Agent - Health6/17/20142/11/2019
ActiveManhattanLife Insurance and Annuity Company301795Agent - Health10/22/2020 
ActiveManhattanLife Insurance and Annuity Company301795Agent - Life3/8/2022 
InactiveMarquette National Life Insurance Company300117Agent - Health11/12/20089/13/2012
InactiveMarquette National Life Insurance Company300117Agent - Life11/12/20089/13/2012
ActiveMedco Containment Life Insurance Company301557Agent - Health12/1/2024 
ActiveMedico Corp Life Insurance Company301777Agent - Health6/5/2025 
ActiveMedico Corp Life Insurance Company301777Agent - Life6/5/2025 
InactiveMedico Insurance Company301559Agent - Health1/12/202312/23/2024
InactiveMedico Insurance Company301559Agent - Life1/12/202312/23/2024
InactiveMedico Life and Health Insurance Company907406Agent - Health1/3/201912/28/2020
InactiveMedico Life and Health Insurance Company907406Agent - Life1/3/201912/28/2020
ActiveMolina Healthcare of Kentucky, Inc.1035856Agent - Health7/23/2021 
ActiveMutual of Omaha Insurance Company301012Agent - Health6/14/2005 
InactiveNassau Life Insurance Company of Kansas300667Agent - Health11/12/20081/30/2013
InactiveNassau Life Insurance Company of Kansas300667Agent - Life11/12/200812/13/2012
ActiveNational Health Insurance Company300554Agent - Health6/24/2022 
ActiveNational Health Insurance Company300554Agent - Life6/24/2022 
InactiveNational Western Life Insurance Company301515Agent - Life9/6/201111/27/2018
InactiveOmaha Insurance Company751908Agent - Health4/17/20129/19/2019
InactivePacifiCare Life and Health Insurance Company301304Agent - Health4/5/201011/6/2011
ActivePan-American Life Insurance Company301530Agent - Life1/1/2024 
ActivePekin Life Insurance Company300951Agent - Health10/19/2017 
ActivePekin Life Insurance Company300951Agent - Life10/19/2017 
InactivePennsylvania Life Insurance Company301321Agent - Health11/12/20083/31/2013
InactivePennsylvania Life Insurance Company301321Agent - Life11/12/20083/31/2013
ActivePhiladelphia American Life Insurance Company300178Agent - Health8/18/2021 
ActivePhiladelphia American Life Insurance Company300178Agent - Life8/18/2021 
InactivePuritan Life Insurance Company of America301892Agent - Health4/28/20088/18/2008
InactivePuritan Life Insurance Company of America301892Agent - Life4/28/20088/18/2008
InactiveShenandoah Life Insurance Company300130Agent - Health11/27/20063/31/2009
ActiveSilverScript Insurance Company663526Agent - Health10/19/2019 
InactiveStandard Life and Accident Insurance Company301534Agent - Health8/13/201811/15/2022
InactiveStandard Life and Accident Insurance Company301534Agent - Life8/13/201811/15/2022
ActiveTier One Insurance Company301056Agent - Health10/24/2022 
ActiveTier One Insurance Company301056Agent - Life8/17/2022 
InactiveTime Insurance Company300683Agent - Health1/14/201412/20/2014
InactiveTime Insurance Company300683Agent - Life1/14/201412/20/2014
ActiveTransamerica Life Insurance Company300571Agent - Health10/1/2020 
ActiveTransamerica Life Insurance Company300571Agent - Life10/1/2020 
InactiveTransamerica Premier Life Insurance Company300558Agent - Health1/28/202010/1/2020
InactiveTransamerica Premier Life Insurance Company300558Agent - Life1/28/202010/1/2020
ActiveUnited American Insurance Company300910Agent - Health8/8/2018 
ActiveUnited American Insurance Company300910Agent - Life8/8/2018 
InactiveUnited Teacher Associates Insurance Company300747Agent - Health10/4/200412/31/2012
InactiveUnited Teacher Associates Insurance Company300747Agent - Life10/4/200412/31/2012
InactiveUnited World Life Insurance Company300532Agent - Health6/15/200512/15/2010
ActiveUnited of Omaha Life Insurance Company300156Agent - Health6/15/2005 
ActiveUnited of Omaha Life Insurance Company300156Agent - Life6/15/2005 
ActiveUnitedHealthcare Insurance Company300946Agent - Health4/5/2010 
InactiveUnitedHealthcare Insurance Company of America301552Agent - Health9/16/201612/20/2018
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health8/5/201912/22/2022
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health7/15/201812/23/2021
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health4/5/201012/5/2016
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health9/13/2015 
ActiveWellCare Health Insurance Company of Kentucky, Inc.301478Agent - Health4/6/2022 
ActiveWellCare Prescription Insurance Inc.654329Agent - Health4/6/2022 
ActiveWellpoint Life and Health Insurance Company300469Agent - Health8/3/2023 
ActiveWellpoint Life and Health Insurance Company300469Agent - Life8/3/2023 
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAnderson, William Randolph 747427Agent - Health4/4/20116/30/2013
InactiveAnderson, William Randolph 747427Agent - Life4/4/20116/30/2013
ActiveGraham, Gary Michael 646224Agent - Health8/17/2012 
ActiveGraham, Gary Michael 646224Agent - Life8/17/2012 
InactiveJudah, Charles Grady 593591Agent - Health9/22/20048/21/2018
InactiveJudah, Charles Grady 593591Agent - Life9/22/20048/21/2018
ActiveMarcum, Kimberly Dawn 638480Agent - Health2/17/2011 
ActiveMarcum, Kimberly Dawn 638480Agent - Life2/17/2011 
InactiveMurrow, Daniel Thomas 626370Agent - Health9/16/200812/1/2024
InactiveMurrow, Daniel Thomas 626370Agent - Life9/16/200812/1/2024
InactiveProffitt, Richard G 384659Agent - Health1/14/20051/31/2007
InactiveProffitt, Richard G 384659Agent - Life1/14/20051/31/2007
InactiveScarboro, David Franklin 316094Agent - Health1/14/20051/31/2007
InactiveScarboro, David Franklin 316094Agent - Life1/14/20051/31/2007
ActiveTomlinson, Kevin Lee 848902Agent - Health9/17/2014 
ActiveTomlinson, Kevin Lee 848902Agent - Life9/17/2014 
ActiveWilliams, Gary K 312293Agent - Health9/16/2008 
ActiveWilliams, Gary K 312293Agent - Life9/16/2008 

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