DEPARTMENT OF INSURANCE

Affiliations

Name	Clark Consulting, LLC DBA : CCG Insurance Solutions, LLC	DOIID	502122	NAIC NPN	2214982

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	12/31/1999	3/31/2025
Active	Non Resident	Agent	Life	12/31/1999	3/31/2025
* 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	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	4/23/2001	7/19/2017
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	4/23/2001	7/19/2017
Active	American General Life Insurance Company	301585	Agent - Health	10/26/2009
Active	American General Life Insurance Company	301585	Agent - Life	10/26/2009
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	7/28/2000	12/31/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	7/28/2000	12/31/2012
Inactive	C.M. Life Insurance Company	301335	Agent - Health	2/4/2002	2/18/2020
Inactive	C.M. Life Insurance Company	301335	Agent - Life	12/15/2000	2/18/2020
Inactive	Clarica Life Insurance Company - U.S.	300207	Agent - Life	5/8/2000	2/18/2003
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	2/12/2001	11/8/2023
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	2/12/2001	11/8/2023
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Health	3/10/2000	1/3/2012
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	3/10/2000	4/1/2023
Inactive	Everlake Life Insurance Company	300873	Agent - Health	12/18/2000	12/2/2011
Inactive	Everlake Life Insurance Company	300873	Agent - Life	12/18/2000	3/21/2004
Inactive	General American Life Insurance Company	300280	Agent - Health	2/11/2000	11/14/2009
Inactive	General American Life Insurance Company	300280	Agent - Life	2/11/2000	11/14/2009
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	10/12/2000	7/2/2007
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	10/12/2000	7/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	10/12/2000	4/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	10/12/2000	4/2/2007
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	4/30/2007	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	4/30/2007	12/30/2009
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	3/13/2002
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	3/13/2002
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Life	11/13/2001	2/24/2009
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	10/8/2002	6/18/2008
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	3/22/2007
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	3/22/2007
Inactive	MML Bay State Life Insurance Company	301198	Agent - Health	2/4/2002	7/22/2010
Inactive	MML Bay State Life Insurance Company	301198	Agent - Life	12/15/2000	7/22/2010
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Health	10/31/2005	2/18/2011
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Life	10/31/2005	2/18/2011
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	2/4/2002	2/18/2020
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	12/15/2000	2/18/2020
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	3/7/2000	11/26/2018
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	3/7/2000	11/26/2018
Active	Midland National Life Insurance Company	300923	Agent - Life	9/10/2003
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	2/22/2000	3/12/2018
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	2/22/2000	3/12/2018
Denied	Nationwide Life and Annuity Insurance Company	300714	Agent - Health
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	2/22/2000	3/12/2018
Active	New York Life Insurance Company	300431	Agent - Health	8/10/2000
Active	New York Life Insurance Company	300431	Agent - Life	8/10/2000
Active	New York Life Insurance and Annuity Corporation	300726	Agent - Health	8/10/2000
Active	New York Life Insurance and Annuity Corporation	300726	Agent - Life	8/10/2000
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	8/3/2006	12/20/2007
Active	Pacific Life Insurance Company	301848	Agent - Health	11/30/2000
Active	Pacific Life Insurance Company	301848	Agent - Life	11/30/2000
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	2/7/2000	12/7/2006
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	2/7/2000	12/7/2006
Inactive	Principal Life Insurance Company	300129	Agent - Health	1/29/2003	11/19/2009
Inactive	Principal Life Insurance Company	300129	Agent - Life	1/29/2003	11/19/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	2/7/2000	9/9/2015
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	2/7/2000	9/9/2015
Inactive	Pruco Life Insurance Company	300954	Agent - Health	10/23/2006	3/1/2017
Inactive	Pruco Life Insurance Company	300954	Agent - Life	10/23/2006	3/1/2017
Inactive	Prudential Insurance Company of America	300784	Agent - Health	2/18/2000	3/1/2017
Inactive	Prudential Insurance Company of America	300784	Agent - Life	2/18/2000	3/1/2017
Inactive	Security Life of Denver Insurance Company	300648	Agent - Health	8/24/2001	9/29/2012
Inactive	Security Life of Denver Insurance Company	300648	Agent - Life	8/24/2001	9/29/2012
Active	Symetra Life Insurance Company	301691	Agent - Health	12/4/2003
Active	Symetra Life Insurance Company	301691	Agent - Life	12/4/2003
Active	Talcott Resolution Life Insurance Company	301759	Agent - Health	8/13/2007
Active	Talcott Resolution Life Insurance Company	301759	Agent - Life	8/13/2007
Active	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	1/25/2002
Active	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	1/25/2002
Inactive	Transamerica Assurance Company	300893	Agent - Health	9/25/2000	8/20/2003
Inactive	Transamerica Assurance Company	300893	Agent - Life	9/25/2000	8/20/2003
Active	Transamerica Life Insurance Company	300571	Agent - Health	12/31/1999
Active	Transamerica Life Insurance Company	300571	Agent - Life	12/31/1999
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	6/13/2002	10/31/2002
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	1/7/2003	7/24/2008
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	2/7/2000	9/9/2015
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	2/7/2000	9/9/2015
Inactive	West Coast Life Insurance Company	301607	Agent - Life	4/11/2001	12/10/2012

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ballou, Kevin	522771	Agent - Health	5/4/2010	9/30/2012
Inactive	Ballou, Kevin	522771	Agent - Life	5/4/2010	9/30/2012
Inactive	Cook, Traci	721883	Agent - Health	3/24/2011	2/17/2017
Inactive	Cook, Traci	721883	Agent - Life	3/24/2011	2/17/2017
Active	Cox, Joanna B	673862	Agent - Health	2/14/2017
Active	Cox, Joanna B	673862	Agent - Life	1/16/2017
Inactive	Huerta, Carlos Alberto	602003	Agent - Health	4/6/2007	5/5/2010
Inactive	Huerta, Carlos Alberto	602003	Agent - Life	4/6/2007	5/5/2010
Denied	Knobel, Jeremy S	606363	Agent - Health
Inactive	Knobel, Jeremy S	606363	Agent - Life	7/24/2007	3/24/2011
Active	Melnick, Richard J	563295	Agent - Life	7/24/2007
Inactive	Moore, Louis L	559939	Agent - Health	7/24/2007	3/24/2011
Inactive	Moore, Louis L	559939	Agent - Life	7/24/2007	3/24/2011
Inactive	Parker, Christopher Lee	524223	Agent - Health	5/4/2001	4/30/2009
Inactive	Parker, Christopher Lee	524223	Agent - Life	5/4/2001	4/30/2009
Active	Przybilla, Eric Robert	640112	Agent - Health	6/28/2007
Active	Przybilla, Eric Robert	640112	Agent - Life	6/28/2007
Inactive	Roth, Ronald Andrew	310252	Agent - Health	12/31/1999	11/16/2000
Inactive	Roth, Ronald Andrew	310252	Agent - Life	12/31/1999	11/16/2000
Inactive	Strapp, Amy Beth	614287	Agent - Health	7/27/2007	3/24/2011
Inactive	Strapp, Amy Beth	614287	Agent - Life	7/27/2007	3/24/2011
Inactive	Wamberg, Warren T	348349	Agent - Health	11/16/2000	1/9/2004
Inactive	Wamberg, Warren T	348349	Agent - Life	11/16/2000	1/9/2004