DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Long, William	DOIID	1066279	NAIC NPN	19301292

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	11/22/2019	8/31/2021
Inactive	Non Resident	Agent	Life	11/22/2019	8/31/2021
* 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	Anthem Life Insurance Company	301209	Agent - Health	4/16/2020	9/19/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/8/2020	9/19/2020
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	12/9/2019	8/31/2021
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	12/9/2019	8/31/2021
Inactive	Independence American Insurance Company	524747	Agent - Health	2/12/2020	12/18/2020
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	2/12/2020	8/31/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	5/11/2020	9/25/2020
Inactive	Designated Agent Company Inc.	681257	Agent - Health	5/11/2020	9/25/2020