DEPARTMENT OF INSURANCE

Affiliations

Name	Schrack, Grant Thomas Michael	DOIID	1047466	NAIC NPN	19204096

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	7/17/2019	1/31/2025
Active	Non Resident	Agent	Health	7/17/2019	1/31/2025
* 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	11/15/2024	01/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	10/7/2019
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	10/24/2019
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/11/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	10/7/2019
Inactive	American Continental Insurance Company	643130	Agent - Life	10/24/2019	8/11/2021
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/6/2022
Active	Anthem Life Insurance Company	301209	Agent - Health	5/8/2020
Active	Anthem Life Insurance Company	301209	Agent - Life	3/24/2020
Active	CareSource Kentucky Co.	838179	Agent - Health	5/4/2020
Active	Chesapeake Life Insurance Company (The)	301017	Agent - Health	3/24/2020
Active	Chesapeake Life Insurance Company (The)	301017	Agent - Life	9/13/2021
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	10/24/2019
Active	Golden Rule Insurance Company	301943	Agent - Health	8/8/2019
Active	Golden Rule Insurance Company	301943	Agent - Life	8/8/2019
Active	SilverScript Insurance Company	663526	Agent - Health	10/7/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/12/2019	2/4/2021
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	9/12/2019	2/4/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	9/12/2019	2/4/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/12/2019	2/4/2021
Active	WellCare Health Plans of Kentucky, Inc.	838592	Agent - Health	10/6/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Designated Agent Company Inc.	681257	Agent - Life	3/24/2020
Active	Designated Agent Company Inc.	681257	Agent - Health	3/24/2020
Active	HealthMarkets Insurance Agency Inc	709727	Agent - Life	1/3/2022
Active	HealthMarkets Insurance Agency Inc	709727	Agent - Health	1/3/2022