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	Life	12/31/1999	3/31/2027
Active	Non Resident	Agent	Health	12/31/1999	3/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

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
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	8/13/2007	4/5/2025
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	8/13/2007	4/5/2025
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