DEPARTMENT OF INSURANCE

Affiliations

Name	Klug, Thomas Mark	DOIID	816500	NAIC NPN	16892932

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	10/9/2019	5/31/2027
Active	Non Resident	Agent	Health	10/9/2019	5/31/2027
* 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
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/27/2021
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	3/8/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/27/2021	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/27/2021	4/15/2025
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	5/8/2014	12/5/2014
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/16/2021
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	5/8/2014	12/5/2014
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	5/2/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	5/8/2014	5/2/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	5/8/2014	5/2/2016
Inactive	Humana Insurance Company	301104	Agent - Health	5/8/2014	5/2/2016
Inactive	Humana Insurance Company	301104	Agent - Life	5/8/2014	5/2/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/8/2014	5/2/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	5/8/2014	5/2/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	5/2/2016
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	5/31/2017
Inactive	Kanawha Insurance Company	300127	Agent - Health	5/8/2014	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	5/8/2014	12/5/2014
Inactive	RiverLink Health of Kentucky, Inc.	834205	Agent - Health	8/30/2015	5/4/2017
Inactive	StableView Health, Inc.	834204	Agent - Health	8/30/2015	11/25/2015
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	10/9/2019
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	10/9/2019	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/9/2019	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/9/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/18/2014	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/18/2014	11/2/2016