DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Williams, Derrick David	DOIID	1119539	NAIC NPN	2665134

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	2/4/2021		7/31/2025
Active	Non Resident	Agent	Life	2/4/2021		7/31/2025
* 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	05/15/2025	07/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/9/2024	9/19/2024
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	10/3/2021	3/4/2022
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	8/9/2024	9/19/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/9/2024	9/19/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/9/2024	9/19/2024
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	10/3/2022
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	2/11/2021	8/19/2024
Active	CompBenefits Insurance Company	301864	Agent - Health	9/23/2022
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	8/9/2024	9/19/2024
Active	Dental Concern Inc. (The)	301641	Agent - Health	4/21/2023
Inactive	Golden Rule Insurance Company	301943	Agent - Health	10/4/2021	12/13/2024
Inactive	Golden Rule Insurance Company	301943	Agent - Life	10/4/2021	12/13/2024
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/4/2022
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	12/14/2022
Active	Humana Health Plan, Inc.	300142	Agent - Health	12/28/2023
Active	Humana Insurance Company	301104	Agent - Health	9/23/2022
Active	Humana Medical Plan, Inc.	801568	Agent - Health	10/3/2022
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	9/26/2022

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	5/15/2024
Inactive	Assurance IQ, LLC	919554	Agent - Health	3/27/2023	5/15/2024
Inactive	Humana MarketPOINT Inc.	398092	Agent - Life	6/2/2023	12/13/2024
Active	Humana MarketPOINT Inc.	398092	Agent - Health	6/2/2023