DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Derron	DOIID	1136284	NAIC NPN	13422982

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	5/25/2021	11/30/2027
Active	Non Resident	Agent	Health	5/25/2021	11/30/2027
* 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	09/15/2025	11/30/2025	09/03/2025	09/03/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Life	11/2/2023	9/25/2025
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	6/2/2021	10/22/2025
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	11/2/2023	9/25/2025
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	6/2/2021	10/22/2025
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/2/2021	10/22/2025
Inactive	American General Life Insurance Company	301585	Agent - Health	11/26/2021	12/10/2024
Inactive	American General Life Insurance Company	301585	Agent - Life	11/26/2021	12/10/2024
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	7/17/2025
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	5/8/2022	5/6/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	7/17/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/14/2021	2/15/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/14/2021	2/15/2022
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	10/6/2025
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/30/2025
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	6/8/2021	9/20/2022
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	6/8/2021	9/20/2022
Inactive	Columbian Life Insurance Company	300810	Agent - Life	2/12/2024	3/7/2024
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	7/17/2025
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	11/2/2023	9/25/2025
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	11/2/2023	9/25/2025
Active	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	9/9/2025
Active	Emphesys Insurance Company	300598	Agent - Health	11/4/2025
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	12/7/2021	5/20/2022
Active	Humana Insurance Company	301104	Agent - Health	10/24/2025
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/1/2025
Active	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	8/23/2025
Inactive	SilverScript Insurance Company	663526	Agent - Health	6/2/2021	10/22/2025
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	7/30/2025
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/11/2022	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/14/2021	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	7/30/2025
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	11/4/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	eHealthInsurance Services Inc.	514105	Agent - Health	9/22/2025