DEPARTMENT OF INSURANCE
Affiliations
NameClark, Kristin ConleyDOIID324567NAIC NPN7169961
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveResidentAgentLife4/14/1993 5/31/2026
ActiveResidentAgentHealth4/14/1993 5/31/2026
ActiveResidentAgentCasualty8/15/2000 5/31/2026
ActiveResidentAgentVariable Life and Variable Annuities5/31/2001 5/31/2026
ActiveResidentAgentProperty8/15/2000 5/31/2026
InactiveResidentAgentGeneral Lines4/14/19938/15/2000 
InactiveResidentAgentHealth Maintenance Organization11/19/19933/1/2001 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAgri General Insurance Company300914Agent - General Lines3/23/199412/3/1998
InactiveAmerican Heritage Life Insurance Company300272Agent - Health10/9/20007/19/2006
InactiveAmerican Heritage Life Insurance Company300272Agent - Life10/9/20007/19/2006
ActiveAmerican Modern Home Insurance Company300791Agent - Casualty1/26/2023 
ActiveAmerican Modern Home Insurance Company300791Agent - Property1/26/2023 
ActiveAmerican Modern Property and Casualty Insurance Company301954Agent - Casualty11/2/2018 
ActiveAmerican Modern Property and Casualty Insurance Company301954Agent - Property11/2/2018 
InactiveAmerican Modern Select Insurance Company581481Agent - Casualty7/27/201511/14/2021
InactiveAmerican Modern Select Insurance Company581481Agent - Property7/27/201511/14/2021
InactiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health3/1/20014/1/2002
InactiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health Maintenance Organization11/19/19933/1/2001
ActiveAnthem Insurance Companies, Inc.300941Agent - Health6/12/2021 
InactiveAssurity Life Insurance Company301099Agent - Health9/1/20041/22/2009
InactiveAssurity Life Insurance Company301099Agent - Life9/1/20041/22/2009
InactiveBankers Fidelity Life Insurance Company300193Agent - Health9/8/201412/21/2015
InactiveBankers Fidelity Life Insurance Company300193Agent - Life9/8/201412/21/2015
ActiveBerkshire Life Insurance Company of America300983Agent - Health11/11/2004 
ActiveBerkshire Life Insurance Company of America300983Agent - Life11/11/2004 
ActiveBristol West Insurance Company301655Agent - Casualty1/30/2008 
ActiveBristol West Insurance Company301655Agent - Property1/30/2008 
ActiveDairyland Insurance Company301370Agent - Casualty10/29/2002 
ActiveFB Insurance Company (The)301763Agent - Casualty8/15/2000 
InactiveFB Insurance Company (The)301763Agent - General Lines4/14/19938/15/2000
ActiveFB Insurance Company (The)301763Agent - Property8/15/2000 
ActiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Casualty7/2/2004 
ActiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Property7/2/2004 
InactiveGuardian Life Insurance Company of America301316Agent - Health11/11/200410/5/2021
InactiveGuardian Life Insurance Company of America301316Agent - Life11/11/200410/5/2021
InactiveIndependence American Insurance Company524747Agent - Health7/8/201912/18/2020
InactiveJohn Hancock Life Insurance Company300821Agent - Health11/4/200512/30/2009
InactiveJohn Hancock Life Insurance Company300821Agent - Life11/4/200512/30/2009
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Health9/19/200812/13/2013
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life9/19/20086/8/2011
ActiveKentucky Farm Bureau Mutual Insurance Company300570Agent - Casualty8/15/2000 
InactiveKentucky Farm Bureau Mutual Insurance Company300570Agent - General Lines4/14/19938/15/2000
ActiveKentucky Farm Bureau Mutual Insurance Company300570Agent - Property8/15/2000 
ActiveSouthern Farm Bureau Life Insurance Company300909Agent - Health4/14/1993 
ActiveSouthern Farm Bureau Life Insurance Company300909Agent - Life4/14/1993 
InactiveSouthern Farm Bureau Life Insurance Company300909Agent - Variable Life and Variable Annuities5/31/20015/10/2011
InactiveStandard Insurance Company300185Agent - Health8/18/201512/5/2022
InactiveStandard Insurance Company300185Agent - Life8/18/201512/5/2022
InactiveStandard Insurance Company300185Agent - Variable Life and Variable Annuities8/18/201512/5/2022
InactiveVictoria Fire & Casualty Company300313Agent - Casualty5/2/20116/23/2017
InactiveVictoria Fire & Casualty Company300313Agent - Property5/2/20116/23/2017
Inactive300277Agent - Health3/24/19979/14/1999
Inactive300277Agent - Life3/24/19979/14/1999
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveDental Choice Agency Inc.398085Agent - Health8/14/2017 
ActiveDesignated Agent Company Inc.681257Agent - Life12/11/2013 
ActiveDesignated Agent Company Inc.681257Agent - Health12/11/2013 
InactiveKentucky Farm Bureau Insurance Agency LLC399619Agent - General Lines7/20/19958/15/2000
ActiveKentucky Farm Bureau Insurance Agency LLC399619Agent - Life7/20/1995 
ActiveKentucky Farm Bureau Insurance Agency LLC399619Agent - Health7/20/1995 
ActiveKentucky Farm Bureau Insurance Agency LLC399619Agent - Property8/15/2000 
ActiveKentucky Farm Bureau Insurance Agency LLC399619Agent - Casualty8/15/2000 
InactiveKristin Clark Insurance Inc.509495Agent - General Lines6/2/20008/15/2000
ActiveKristin Clark Insurance Inc.509495Agent - Life3/31/2003 
ActiveKristin Clark Insurance Inc.509495Agent - Health3/31/2003 
ActiveKristin Clark Insurance Inc.509495Agent - Property3/31/2003 
ActiveKristin Clark Insurance Inc.509495Agent - Casualty3/31/2003 
ActivePlanchoice Inc.400482Agent - Health4/17/2014 
InactiveSouthern Capital Brokerage Co LLC577403Agent - Life9/24/20043/31/2007
InactiveSouthern Capital Brokerage Co LLC577403Agent - Health9/24/20043/31/2007

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