DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Black Gould & Assoc Inc	DOIID	1048488	NAIC NPN	954035

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	7/24/2019		3/31/2025
Active	Non Resident	Agent	Health	7/24/2019		3/31/2025
* 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	01/15/2025	03/31/2025

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	7/23/2023
Inactive	Accendo Insurance Company	300312	Agent - Health	9/10/2021	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	4/9/2021
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/24/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	4/9/2021
Active	Ameritas Life Insurance Corporation	300126	Agent - Health	3/29/2021
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	6/23/2023
Active	Globe Life and Accident Insurance Company	300639	Agent - Health	2/1/2024
Active	Globe Life and Accident Insurance Company	300639	Agent - Life	2/1/2024
Active	Golden Rule Insurance Company	301943	Agent - Health	8/13/2019
Active	Golden Rule Insurance Company	301943	Agent - Life	8/13/2019
Active	SilverScript Insurance Company	663526	Agent - Health	5/22/2020
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	4/6/2022
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	4/6/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Gould, William Bradford	381265	Agent - Health	7/24/2019
Active	Gould, William Bradford	381265	Agent - Life	7/24/2019