DEPARTMENT OF INSURANCE

Affiliations

Name	Alta Vista Benefits LLC	DOIID	860021	NAIC NPN	17351041

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	11/12/2014	3/31/2026
Denied	Non Resident	Agent	Life
Withdrawn	Non Resident	Managing General Agent	Not Applicable
* 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
Active	ACE Property and Casualty Insurance Company	300520	Agent - Health	12/13/2022
Inactive	Accendo Insurance Company	300312	Agent - Health	9/10/2021	11/17/2023
Active	Aetna Health Inc. (PA)	660717	Agent - Health	9/10/2019
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	12/22/2023
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/6/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	2/20/2015
Active	All Savers Insurance Company	301940	Agent - Health	4/23/2024
Active	Ameritas Life Insurance Corporation	300126	Agent - Health	11/4/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/18/2017	4/29/2019
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Active	CareSource Kentucky Co.	838179	Agent - Health	8/31/2020
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	5/17/2019	1/6/2025
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018
Inactive	Elips Life Insurance Company	301087	Agent - Health	4/14/2022	1/23/2025
Active	First Health Life & Health Insurance Company	301735	Agent - Health	2/20/2015
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/19/2014	12/8/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	11/19/2014	12/8/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/18/2017	6/15/2018
Active	Humana Insurance Company	301104	Agent - Health	11/29/2021
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/19/2014	12/8/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	11/19/2014	12/8/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/19/2014	10/22/2015
Inactive	Lasso Healthcare Insurance Company	1022651	Agent - Health	7/22/2023	12/22/2023
Inactive	Lumico Life Insurance Company	300354	Agent - Health	12/19/2018	2/17/2023
Active	MedMutual Life Insurance Company	301047	Agent - Health	4/25/2025
Active	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	9/16/2022
Active	National Health Insurance Company	300554	Agent - Health	1/26/2023
Active	Reserve National Insurance Company	301073	Agent - Health	4/15/2025
Active	SilverScript Insurance Company	663526	Agent - Health	10/20/2019
Active	Tier One Insurance Company	301056	Agent - Health	10/24/2022
Inactive	Union Security Insurance Company	301844	Agent - Health	8/14/2018	2/15/2021
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	4/18/2022
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/16/2016	12/20/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	4/10/2022	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	4/18/2022	12/17/2024
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	4/23/2024
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	4/10/2022
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	2/21/2023	3/1/2025
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	7/25/2023	3/1/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Grosz, Lucille B	699108	Agent - Health	11/12/2014
Denied	Grosz, Lucille B	699108	Agent - Life