DEPARTMENT OF INSURANCE

Affiliations

Name	Roberts, Gavin Clayton	DOIID	304441	NAIC NPN	7157610

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	5/31/2001		8/31/2024
Active	Resident	Agent	Property	3/26/2001		8/31/2024
Active	Resident	Agent	Health	5/31/2001		8/31/2024
Active	Resident	Agent	Casualty	5/31/2001		8/31/2024
Inactive	Resident	Apprentice Adjuster	Not Applicable	10/7/1999	6/28/2000
* 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	06/15/2024	08/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Agricultural Insurance Company	300215	Agent - Property	10/9/2015	6/16/2021
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	2/7/2019	4/14/2023
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	2/7/2019	4/14/2023
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	4/5/2004	6/23/2008
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	4/5/2004	6/23/2008
Active	American Modern Home Insurance Company	300791	Agent - Casualty	1/26/2023
Active	American Modern Home Insurance Company	300791	Agent - Property	1/26/2023
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	10/9/2018
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	10/9/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	10/11/2016	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	10/11/2016	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	6/19/2017	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	6/19/2017	11/14/2021
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	4/30/2023
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/26/2021
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	3/5/2015	12/5/2017
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	3/5/2015	12/5/2017
Active	Bristol West Insurance Company	301655	Agent - Casualty	2/11/2008
Active	Bristol West Insurance Company	301655	Agent - Property	2/11/2008
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/16/2021
Active	Dairyland Insurance Company	301370	Agent - Casualty	5/31/2001
Active	FB Insurance Company (The)	301763	Agent - Casualty	5/31/2001
Active	FB Insurance Company (The)	301763	Agent - Property	3/26/2001
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/16/2004
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/16/2004
Active	Illinois Mutual Life Insurance Company	301479	Agent - Health	1/23/2018
Active	Illinois Mutual Life Insurance Company	301479	Agent - Life	1/23/2018
Inactive	Independence American Insurance Company	524747	Agent - Health	10/9/2020	12/30/2022
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	11/1/2005	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	11/1/2005	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/19/2008	3/19/2017
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/19/2008	3/19/2017
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	5/31/2001
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	3/26/2001
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	8/18/2016	9/20/2018
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	7/26/2018	3/30/2020
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	5/31/2001
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	5/31/2001
Inactive	Standard Insurance Company	300185	Agent - Health	3/3/2014	12/5/2022
Inactive	Standard Insurance Company	300185	Agent - Life	3/3/2014	12/5/2022
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	8/26/2016	12/27/2018
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	8/26/2016	12/27/2018
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	5/4/2011	6/26/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	5/4/2011	6/26/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	11/9/2009	1/9/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/12/2013	10/5/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/12/2013	10/5/2021
Active	Gavin C. Roberts Insurance Agency, Inc.	680772	Agent - Life	5/15/2008
Active	Gavin C. Roberts Insurance Agency, Inc.	680772	Agent - Health	5/15/2008
Active	Gavin C. Roberts Insurance Agency, Inc.	680772	Agent - Property	5/15/2008
Active	Gavin C. Roberts Insurance Agency, Inc.	680772	Agent - Casualty	5/15/2008
Inactive	Gavin C. Roberts Insurance, LLC	624432	Agent - Life	1/20/2006	6/2/2008
Inactive	Gavin C. Roberts Insurance, LLC	624432	Agent - Health	1/20/2006	6/2/2008
Inactive	Gavin C. Roberts Insurance, LLC	624432	Agent - Property	1/20/2006	6/2/2008
Inactive	Gavin C. Roberts Insurance, LLC	624432	Agent - Casualty	1/20/2006	6/2/2008
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	4/16/2001
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	4/16/2001
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	4/16/2001
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	4/16/2001
Active	Planchoice Inc.	400482	Agent - Health	4/17/2014
Inactive	Southern Capital Brokerage Co LLC	577403	Agent - Life	9/7/2004	3/31/2007
Active	Southern Capital Brokerage Co LLC	577403	Agent - Health	2/5/2019