DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Triple Crown Industries DBA : Triple Crown Management	DOIID	1283362	NAIC NPN	20770083

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	8/20/2025		3/31/2027
Active	Resident	Agent	Health	8/20/2025		3/31/2027
Denied	Resident	Agent	Casualty
Denied	Resident	Agent	Property
* 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	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	12/16/2025
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	12/16/2025
Active	Philadelphia American Life Insurance Company	300178	Agent - Health	2/10/2026
Active	Philadelphia American Life Insurance Company	300178	Agent - Life	2/10/2026

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Anderson, Blake	1277046	Agent - Casualty
Active	Anderson, Blake	1277046	Agent - Health	8/20/2025
Active	Anderson, Blake	1277046	Agent - Life	8/20/2025
Denied	Anderson, Blake	1277046	Agent - Property