DEPARTMENT OF INSURANCE
Affiliations
NameFinancial GradeDOIID721194NAIC NPN9888327
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth1/15/2010 3/31/2026
ActiveNon ResidentAgentLife1/15/2010 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
ActiveACE Property and Casualty Insurance Company300520Agent - Health5/15/2025 
InactiveAccendo Insurance Company300312Agent - Health6/22/202211/17/2023
ActiveAccendo Insurance Company300312Agent - Life6/10/2020 
ActiveAetna Health Inc. (PA)660717Agent - Health2/2/2010 
ActiveAetna Health Insurance Company301583Agent - Health9/4/2014 
ActiveAetna Health and Life Insurance Company300523Agent - Health8/24/2016 
ActiveAetna Health of Ohio Inc.1065035Agent - Health7/24/2020 
ActiveAetna Life Insurance Company301140Agent - Health2/2/2010 
ActiveAetna Life Insurance Company301140Agent - Life2/2/2010 
InactiveAmerican Continental Insurance Company643130Agent - Health6/24/201311/12/2014
InactiveAmerican Continental Insurance Company643130Agent - Life6/24/201311/12/2014
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health10/25/2017 
InactiveAnthem Health Plans of New Hampshire, Inc.944064Agent - Health12/6/202112/19/2024
ActiveAnthem Insurance Companies, Inc.300941Agent - Health12/6/2021 
InactiveAnthem Life Insurance Company301209Agent - Health10/25/20174/15/2025
InactiveAnthem Life Insurance Company301209Agent - Life10/25/20174/15/2025
ActiveArcadian Health Plan, Inc.728196Agent - Health10/24/2017 
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health7/20/2022 
InactiveCompBenefits Dental, Inc.591692Agent - Health6/24/20143/14/2019
ActiveCompcare Health Services Insurance Corporation948751Agent - Health9/25/2021 
InactiveConseco Health Insurance Company301725Agent - Health1/27/201010/1/2010
InactiveConseco Health Insurance Company301725Agent - Life1/27/201010/1/2010
InactiveConseco Insurance Company301202Agent - Health1/27/201010/1/2010
InactiveConseco Insurance Company301202Agent - Life1/27/201010/1/2010
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health3/6/2018 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Life6/22/2022 
ActiveCoventry Health and Life Insurance Company301771Agent - Health9/15/2014 
ActiveDental Concern Inc. (The)301641Agent - Health6/24/2014 
ActiveFirst Health Life & Health Insurance Company301735Agent - Health5/25/2012 
ActiveGerber Life Insurance Company300529Agent - Health9/20/2018 
ActiveGerber Life Insurance Company300529Agent - Life9/20/2018 
InactiveGolden Rule Insurance Company301943Agent - Health6/22/201512/13/2016
InactiveGolden Rule Insurance Company301943Agent - Life6/22/201512/14/2016
InactiveGovernment Personnel Mutual Life Insurance Company301862Agent - Health6/21/20108/15/2012
InactiveGovernment Personnel Mutual Life Insurance Company301862Agent - Life6/21/20108/15/2012
ActiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health1/23/2016 
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health6/24/20142/23/2018
ActiveHumana Health Plan, Inc.300142Agent - Health6/24/2014 
ActiveHumana Insurance Company301104Agent - Health6/24/2014 
ActiveHumana Insurance Company301104Agent - Life6/24/2014 
ActiveHumana Insurance Company of Kentucky300826Agent - Health6/24/2014 
ActiveHumana Insurance Company of Kentucky300826Agent - Life6/24/2014 
InactiveKanawha Insurance Company300127Agent - Health6/24/201410/22/2015
InactiveKanawha Insurance Company300127Agent - Life6/24/201410/22/2015
InactiveLumico Life Insurance Company300354Agent - Life8/17/202211/20/2024
ActiveMedco Containment Life Insurance Company301557Agent - Health11/19/2024 
InactiveMedico Corp Life Insurance Company301777Agent - Health3/18/20153/23/2018
InactiveMedico Corp Life Insurance Company301777Agent - Life3/18/20153/23/2018
InactiveMedico Insurance Company301559Agent - Health3/18/201512/26/2018
InactiveMedico Insurance Company301559Agent - Life3/18/201512/26/2018
ActiveMolina Healthcare of Kentucky, Inc.1035856Agent - Health10/7/2022 
InactiveMutual of Omaha Insurance Company301012Agent - Health1/20/201012/26/2012
InactiveOmaha Insurance Company751908Agent - Health7/11/20131/27/2014
ActiveSilverScript Insurance Company663526Agent - Health12/19/2019 
InactiveUnited of Omaha Life Insurance Company300156Agent - Health1/20/201012/26/2012
InactiveUnited of Omaha Life Insurance Company300156Agent - Life1/20/201012/26/2012
ActiveUnitedHealthcare Insurance Company300946Agent - Health6/10/2014 
InactiveUnitedHealthcare Insurance Company of America301552Agent - Health9/11/201612/20/2018
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health8/5/201912/22/2022
InactiveUnitedHealthcare Life Insurance Company301517Agent - Health6/22/201511/4/2016
InactiveUnitedHealthcare Life Insurance Company301517Agent - Life6/22/201511/4/2016
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health7/15/201812/23/2021
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health6/10/201412/5/2016
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health9/10/2015 
InactiveWashington National Insurance Company300587Agent - Health10/1/20102/26/2014
InactiveWashington National Insurance Company300587Agent - Life10/1/20102/26/2014
ActiveWellCare Health Insurance Company of Kentucky, Inc.301478Agent - Health4/7/2022 
ActiveWellCare Prescription Insurance Inc.654329Agent - Health12/20/2018 
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveBlasi, Peter Simon 691302Agent - Health1/15/2010 
ActiveBlasi, Peter Simon 691302Agent - Life1/15/2010 

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