DEPARTMENT OF INSURANCE

Affiliations

Name	Lacy, Patrick Benjamin	DOIID	1085491	NAIC NPN	18877578

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	6/5/2020	1/31/2023
Inactive	Non Resident	Agent	Health	6/5/2020	1/31/2023
* 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	Accendo Insurance Company	300312	Agent - Health	9/10/2021	12/10/2021
Inactive	Accendo Insurance Company	300312	Agent - Life	7/28/2021	12/10/2021
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	6/12/2020	7/7/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	6/19/2020	12/10/2021
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	12/8/2020	7/7/2022
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/12/2020	7/7/2022
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	12/6/2020	1/31/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	12/6/2020	1/31/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Life	12/6/2020	1/31/2023
Inactive	Capitol Life Insurance Company	301514	Agent - Health	8/1/2020	12/5/2021
Inactive	CompBenefits Insurance Company	301864	Agent - Health	8/6/2020	12/15/2020
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	6/19/2020	12/10/2021
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	7/28/2021	12/10/2021
Inactive	GPM Health and Life Insurance Company	927255	Agent - Health	12/3/2020	7/15/2022
Inactive	Lumico Life Insurance Company	300354	Agent - Health	1/12/2021	1/10/2022
Inactive	ManhattanLife Insurance and Annuity Company	301795	Agent - Health	12/9/2020	1/31/2023
Inactive	SilverScript Insurance Company	663526	Agent - Health	6/12/2020	7/7/2022
Inactive	Southern Guaranty Insurance Company	969411	Agent - Health	6/19/2020	10/26/2021
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/7/2020	12/7/2021
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	12/13/2020	12/7/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	12/13/2020	12/7/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	12/13/2020	12/7/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Smart Match Insurance Agency LLC	829381	Agent - Health	2/26/2021	6/2/2021
Inactive	Smart Match Insurance Agency LLC	829381	Agent - Life	2/26/2021	6/2/2021
Inactive	Spring Ins Solutions LLC	788951	Agent - Health	7/2/2020	6/2/2021
Denied	Spring Ins Solutions LLC	788951	Agent - Life