DEPARTMENT OF INSURANCE
Affiliations
NameClark, David SamuelDOIID1130743NAIC NPN19608712
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth3/28/2025 3/31/2026
InactiveNon ResidentAgentLife4/21/20213/31/2024 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202603/31/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAccendo Insurance Company300312Agent - Life11/14/20233/31/2024
InactiveAetna Health Inc. (PA)660717Agent - Health5/3/20213/31/2024
InactiveAetna Health and Life Insurance Company300523Agent - Health11/14/20233/31/2024
ActiveAetna Health of Ohio Inc.1065035Agent - Health4/3/2025 
ActiveAetna Life Insurance Company301140Agent - Health4/3/2025 
InactiveAmerican General Life Insurance Company301585Agent - Health2/21/20233/31/2024
InactiveAmerican General Life Insurance Company301585Agent - Life2/21/20233/31/2024
InactiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health8/8/20233/31/2024
InactiveAnthem Health Plans of New Hampshire, Inc.944064Agent - Health8/8/20233/31/2024
InactiveAnthem Insurance Companies, Inc.300941Agent - Health8/8/20233/31/2024
InactiveCare Improvement Plus South Central Insurance Company799697Agent - Health6/4/202511/26/2025
InactiveCompcare Health Services Insurance Corporation948751Agent - Health8/8/20233/31/2024
InactiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health11/14/20233/31/2024
InactiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Life11/14/20233/31/2024
ActiveDevoted Health Insurance Company of Kentucky, Inc.1306593Agent - Health4/7/2025 
InactiveGreat Southern Life Insurance Company301443Agent - Health7/10/202112/11/2023
ActiveHumana Insurance Company301104Agent - Health8/6/2025 
ActiveSilverScript Insurance Company663526Agent - Health4/3/2025 
InactiveUnitedHealthcare Insurance Company300946Agent - Health7/27/202112/2/2022
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health7/27/202112/2/2022
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health7/27/202112/23/2021
InactiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health7/27/202112/2/2022
ActiveWellCare Health Insurance Company of Kentucky, Inc.301478Agent - Health8/26/2025 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveHealth Iq Insurance Services, Inc882220Agent - Life9/21/202111/28/2021
InactiveHealth Iq Insurance Services, Inc882220Agent - Health9/21/20213/2/2023

© Commonwealth of Kentucky. All rights reserved.