DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Relation Insurance Services of California, Inc.	DOIID	741250	NAIC NPN	13936509

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/29/2010		3/31/2026
Active	Non Resident	Agent	Life	10/29/2010		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

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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/5/2012	10/20/2018
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/5/2012	10/20/2018
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/5/2012	10/20/2018
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	1/30/2012	9/3/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/30/2012	9/3/2013
Inactive	Humana Insurance Company	301104	Agent - Health	1/30/2012	9/3/2013
Inactive	Humana Insurance Company	301104	Agent - Life	1/30/2012	9/3/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/30/2012	9/3/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/30/2012	9/3/2013

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Jones Gyllstrom, Nicole	709596	Agent - Health	10/29/2010	6/17/2015
Inactive	Jones Gyllstrom, Nicole	709596	Agent - Life	10/29/2010	6/17/2015
Denied	Martin, Stephen Douglas	859805	Agent - Health
Denied	Martin, Stephen Douglas	859805	Agent - Life
Active	Varni, Keri Ann	865527	Agent - Health	4/29/2015
Active	Varni, Keri Ann	865527	Agent - Life	4/29/2015