DEPARTMENT OF INSURANCE

Affiliations

Name	Carbillano, Mark A	DOIID	598658	NAIC NPN	8083997

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	6/11/2024	6/30/2027
Active	Non Resident	Agent	Health	6/11/2024	6/30/2027
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	8/10/2010	6/30/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/10/2010	6/30/2015
Inactive	Aetna Life Insurance Company	301140	Agent - Life	8/10/2010	6/30/2015
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	1/3/2005	4/1/2007
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	12/28/2010	3/22/2013
Inactive	Companion Life Insurance Company	300191	Agent - Health	12/7/2004	2/19/2007
Inactive	Companion Life Insurance Company	300191	Agent - Life	12/7/2004	2/19/2007
Inactive	Continental General Insurance Company	300691	Agent - Health	12/6/2004	11/11/2005
Inactive	Continental General Insurance Company	300691	Agent - Life	12/6/2004	11/11/2005
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/28/2010	3/22/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	7/2/2013	6/30/2015
Inactive	Humana Insurance Company	301104	Agent - Health	12/28/2010	3/22/2013
Inactive	Humana Insurance Company	301104	Agent - Life	12/28/2010	3/22/2013
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	7/2/2013	6/30/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	7/2/2013	6/30/2015
Inactive	Jefferson National Life Insurance Company	300258	Agent - Life	12/1/2004	6/8/2006
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/28/2010	3/22/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/28/2010	3/22/2013
Inactive	Protective Life Insurance Company	300638	Agent - Life	4/1/2007	12/30/2009
Inactive	Time Insurance Company	300683	Agent - Health	7/19/2007	3/18/2009
Inactive	Time Insurance Company	300683	Agent - Life	7/19/2007	3/18/2009
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/14/2006	4/6/2010
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	6/14/2006	11/9/2012
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	6/14/2006	11/9/2012
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	6/14/2006	4/6/2010
Inactive	WellCare Health Plans of Kentucky, Inc.	838592	Agent - Health	9/25/2024	11/7/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Alera Group, Inc.	941451	Agent - Life
Inactive	Alera Group, Inc.	941451	Agent - Health	10/31/2024	11/7/2024