DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Derrick	DOIID	1087271	NAIC NPN	18395842

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	6/24/2020	7/31/2022
Inactive	Non Resident	Agent	Health	6/24/2020	7/31/2022
* 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 - Life	10/27/2020	7/31/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	10/27/2020	7/31/2022
Inactive	American Continental Insurance Company	643130	Agent - Life	10/27/2020	8/11/2021
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	11/12/2021	7/31/2022
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Health	3/16/2021	4/8/2021
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Life	3/16/2021	4/8/2021
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	3/16/2021	9/19/2022
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	3/16/2021	9/19/2022
Inactive	C.M. Life Insurance Company	301335	Agent - Life	7/31/2020	7/31/2022
Inactive	CMFG Life Insurance Company	300929	Agent - Life	10/3/2020	5/5/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	10/27/2020	7/31/2022
Inactive	Gerber Life Insurance Company	300529	Agent - Health	10/7/2020	7/31/2022
Inactive	Gerber Life Insurance Company	300529	Agent - Life	10/7/2020	7/31/2022
Inactive	MEMBERS Life Insurance Company	301289	Agent - Life	10/7/2021	5/5/2022
Inactive	Pruco Life Insurance Company	300954	Agent - Life	2/16/2021	7/31/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Health Iq Insurance Services, Inc	882220	Agent - Life	8/3/2020	7/31/2022
Inactive	Health Iq Insurance Services, Inc	882220	Agent - Health	10/7/2020	7/31/2022