DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Jalen D	DOIID	1249615	NAIC NPN	20459584

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	1/4/2023	7/31/2026
Active	Non Resident	Agent	Life	1/4/2023	7/31/2026
* 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	05/15/2024	07/31/2024	06/20/2024	06/20/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	1/31/2023	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	1/31/2023
Active	Aetna Health Inc. (PA)	660717	Agent - Health	2/21/2023
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	1/31/2023
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	2/21/2023
Active	Aetna Life Insurance Company	301140	Agent - Health	2/21/2023
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/31/2023
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	1/31/2023
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	1/31/2023
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	3/7/2024
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	1/25/2023
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	1/31/2023
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	1/31/2023
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	1/31/2023
Active	Humana Health Plan, Inc.	300142	Agent - Health	12/26/2023
Active	Humana Insurance Company	301104	Agent - Health	4/21/2023
Active	Humana Medical Plan, Inc.	801568	Agent - Health	7/14/2023
Active	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	8/17/2023
Active	SilverScript Insurance Company	663526	Agent - Health	2/21/2023
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	1/25/2023
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	1/25/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Healthcompare Ins Services Inc	708319	Agent - Life	4/21/2023
Active	Healthcompare Ins Services Inc	708319	Agent - Health	4/21/2023