DEPARTMENT OF INSURANCE

Affiliations

Name	Partners Benefit Group LLC	DOIID	675594	NAIC NPN	9207990

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	5/31/2022		3/31/2026
Inactive	Non Resident	Agent	Health	3/31/2008	9/1/2022
* 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
Inactive	Accendo Insurance Company	300312	Agent - Life	6/10/2020	2/1/2022
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	5/15/2009	9/1/2022
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/10/2020	9/1/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	5/15/2009	9/1/2022
Active	Aetna Life Insurance Company	301140	Agent - Life	2/13/2024
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	5/1/2009	11/3/2016
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	5/1/2009	10/16/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	5/1/2009	11/3/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/1/2009	11/3/2016
Inactive	Banner Life Insurance Company	301696	Agent - Life	1/10/2013	2/1/2022
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	1/16/2020	9/1/2022
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	6/7/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018	9/1/2022
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	2/3/2012	4/15/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	2/3/2012	4/15/2015
Inactive	Humana Insurance Company	301104	Agent - Health	2/3/2012	4/15/2015
Inactive	Humana Insurance Company	301104	Agent - Life	2/3/2012	4/15/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/3/2012	4/15/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/3/2012	4/15/2015
Inactive	Nippon Life Insurance Company of America	300446	Agent - Health	7/15/2018	9/1/2022
Inactive	Nippon Life Insurance Company of America	300446	Agent - Life	7/15/2018	2/1/2022
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/9/2019	9/1/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bradley, Stacy Lynn	1135509	Agent - Health	2/15/2022	6/3/2022
Inactive	Simmons, Gary Marvin	594387	Agent - Health	3/31/2008	11/30/2021
Inactive	Simmons, Gary Marvin	594387	Agent - Life	3/31/2008	11/30/2021
Active	Stokes, Kimberly Dawn	1157629	Agent - Life	5/31/2022
Denied	Willis, Karen Stroud	1207934	Agent - Health
Inactive	Willis, Karen Stroud	1207934	Agent - Life	5/31/2022	4/11/2024