DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Brockington, Blaze Avonte	DOIID	1240755	NAIC NPN	17263802

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Personal Lines	2/24/2023		1/31/2026
Active	Non Resident	Agent	Health	11/4/2022		1/31/2026
* 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	11/15/2025	01/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	12/7/2024
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	12/7/2024
Active	Aetna Life Insurance Company	301140	Agent - Health	12/7/2024
Active	American Strategic Insurance Corp	883540	Agent - Personal Lines	5/14/2024
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	12/7/2022	12/29/2022
Active	Bristol West Insurance Company	301655	Agent - Personal Lines	6/12/2024
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Personal Lines	5/15/2024
Inactive	Liberty Insurance Corporation	300444	Agent - Personal Lines	4/2/2024	5/2/2024
Inactive	Liberty Mutual Insurance Company	301159	Agent - Personal Lines	5/9/2023	5/2/2024
Inactive	Liberty Mutual Personal Insurance Company	959584	Agent - Personal Lines	3/24/2023	5/2/2024
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Personal Lines	4/4/2023	5/2/2024
Active	SilverScript Insurance Company	663526	Agent - Health	12/7/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Qw Insurance Solutions, LLC	1047634	Agent - Health	9/25/2024	11/21/2024