DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Hackman, Thomas Lee	DOIID	326365	NAIC NPN	7172555

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	3/26/2013		7/31/2024
Active	Resident	Agent	Life	3/26/2013		7/31/2024
* 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

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	6/13/2008	12/30/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	6/13/2008	12/30/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	6/13/2008	12/30/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	6/13/2008	12/30/2009
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	5/17/1999	12/1/2000
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	5/17/1999	12/1/2000

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mercer Health & Benefits LLC	607080	Agent - Life	7/2/2008	12/30/2009
Inactive	Mercer Health & Benefits LLC	607080	Agent - Health	7/2/2008	12/30/2009