DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Legacy, Charles Patterson-Shomo	DOIID	1069622	NAIC NPN	3131794

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	1/3/2020	4/30/2023
Inactive	Non Resident	Agent	Life	1/3/2020	4/30/2023
* 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	AXIS Insurance Company	301290	Agent - Health	1/29/2020	4/30/2023
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	6/5/2021	4/30/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	6/5/2021	4/30/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/5/2021	4/30/2023
Inactive	Aspen American Insurance Company	301513	Agent - Health	1/23/2020	12/14/2020
Inactive	Golden Rule Insurance Company	301943	Agent - Health	5/9/2022	5/2/2023
Inactive	Golden Rule Insurance Company	301943	Agent - Life	5/9/2022	5/2/2023
Inactive	Independence American Insurance Company	524747	Agent - Health	3/6/2020	12/21/2021
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	3/4/2020	12/12/2022
Inactive	United States Fire Insurance Company	582240	Agent - Health	9/22/2020	5/8/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Assurance IQ, LLC	919554	Agent - Life	3/27/2023	4/30/2023
Inactive	Assurance IQ, LLC	919554	Agent - Health	3/27/2023	4/30/2023
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	2/11/2020	8/15/2022