DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Charles E	DOIID	706023	NAIC NPN	2772328

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	5/18/2009	10/31/2024
Inactive	Non Resident	Agent	Property	5/18/2009	10/31/2024
Inactive	Non Resident	Agent	Life	5/18/2009	10/31/2024
Inactive	Non Resident	Agent	Health	5/18/2009	10/31/2024
* 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
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	12/22/2009	10/5/2021
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	12/22/2009	10/5/2021
Inactive	Continental Casualty Company	301019	Agent - Casualty	4/26/2012	10/31/2024
Inactive	Continental Casualty Company	301019	Agent - Property	4/26/2012	10/31/2024
Inactive	Doctors Company, an Interinsurance Exchange (The)	301946	Agent - Casualty	10/21/2021	9/16/2024
Inactive	Doctors Company, an Interinsurance Exchange (The)	301946	Agent - Property	10/21/2021	9/16/2024
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	12/22/2009	7/11/2024
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	12/22/2009	7/11/2024
Inactive	Medical Protective Company (The)	301207	Agent - Casualty	7/1/2021	10/31/2024
Inactive	Medical Protective Company (The)	301207	Agent - Property	7/1/2021	10/31/2024
Inactive	ProAssurance Casualty Company	300928	Agent - Casualty	3/28/2011	12/31/2023
Inactive	ProAssurance Indemnity Company, Inc.	301859	Agent - Casualty	12/13/2023	12/23/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Towers Watson Midwest, Inc	534348	Agent - Property	4/26/2012	8/24/2020
Inactive	Willis Towers Watson Midwest, Inc	534348	Agent - Life	12/22/2009	8/24/2020
Inactive	Willis Towers Watson Midwest, Inc	534348	Agent - Casualty	4/26/2012	8/24/2020
Inactive	Willis Towers Watson Midwest, Inc	534348	Agent - Health	12/22/2009	8/24/2020