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DEPARTMENT OF INSURANCE
Affiliations
Name
Burckhard, Chad Michael
DOIID
512583
NAIC NPN
7214292
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Resident
Agent
Casualty
6/25/2015
1/1/2017
Inactive
Resident
Agent
Health
6/29/2015
1/1/2017
Inactive
Resident
Agent
Variable Life and Variable Annuities
4/3/2007
6/18/2009
Inactive
Resident
Agent
Property
6/25/2015
1/1/2017
Inactive
Resident
Agent
Life
6/29/2015
1/1/2017
Denied
Resident
Surplus Lines Broker
Not Applicable
* 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
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
ACUITY, A Mutual Insurance Company
300095
Agent - Casualty
1/13/2014
7/21/2014
Inactive
ACUITY, A Mutual Insurance Company
300095
Agent - Property
1/13/2014
7/21/2014
Inactive
AIG Assurance Company
300897
Agent - Casualty
8/9/2004
4/24/2006
Inactive
AIG Assurance Company
300897
Agent - Property
8/9/2004
4/24/2006
Inactive
Allianz Life Insurance Company of North America
301791
Agent - Health
1/10/2007
10/20/2008
Inactive
Allianz Life Insurance Company of North America
301791
Agent - Life
1/10/2007
10/20/2008
Inactive
Allstate Indemnity Company
300778
Agent - Casualty
5/22/2007
10/19/2007
Inactive
Allstate Indemnity Company
300778
Agent - Property
5/22/2007
10/19/2007
Inactive
Allstate Insurance Company
300773
Agent - Casualty
5/22/2007
10/19/2007
Inactive
Allstate Insurance Company
300773
Agent - Property
5/22/2007
10/19/2007
Inactive
Allstate Property and Casualty Insurance Company
300593
Agent - Casualty
5/22/2007
10/19/2007
Inactive
Allstate Property and Casualty Insurance Company
300593
Agent - Property
5/22/2007
10/19/2007
Inactive
American Heritage Life Insurance Company
300272
Agent - Health
8/29/2005
11/28/2007
Inactive
American Heritage Life Insurance Company
300272
Agent - Life
8/29/2005
11/28/2007
Inactive
American Manufacturers Mutual Insurance Company
301807
Agent - Casualty
10/2/2002
5/31/2003
Inactive
American Manufacturers Mutual Insurance Company
301807
Agent - Property
10/2/2002
5/31/2003
Inactive
American Motorists Insurance Company
301212
Agent - Casualty
10/10/2002
5/31/2003
Inactive
American Motorists Insurance Company
301212
Agent - Property
10/10/2002
5/31/2003
Inactive
American National General Insurance Company
301944
Agent - Casualty
9/10/2012
5/28/2013
Inactive
American National General Insurance Company
301944
Agent - Property
9/10/2012
5/28/2013
Inactive
American National Insurance Company
301861
Agent - Health
9/6/2012
5/28/2013
Inactive
American National Insurance Company
301861
Agent - Life
9/6/2012
5/28/2013
Inactive
American National Property and Casualty Company
300392
Agent - Casualty
9/10/2012
5/28/2013
Inactive
American National Property and Casualty Company
300392
Agent - Property
9/10/2012
5/28/2013
Inactive
Ameritas Life Insurance Corporation
300126
Agent - Health
9/30/2005
6/18/2009
Inactive
Ameritas Life Insurance Corporation
300126
Agent - Life
9/30/2005
6/18/2009
Inactive
Assurance Company of America
300432
Agent - Casualty
7/19/2002
7/5/2006
Inactive
Assurance Company of America
300432
Agent - Property
7/19/2002
7/5/2006
Inactive
Assurity Life Insurance Company
301099
Agent - Health
5/30/2006
7/5/2006
Inactive
Assurity Life Insurance Company
301099
Agent - Life
5/30/2006
7/5/2006
Inactive
Bristol West Insurance Company
301655
Agent - Casualty
10/25/2007
6/18/2009
Inactive
Bristol West Insurance Company
301655
Agent - Property
10/25/2007
6/18/2009
Inactive
Consolidated Insurance Company
300943
Agent - Casualty
9/20/2002
7/5/2006
Inactive
Consolidated Insurance Company
300943
Agent - Property
9/20/2002
7/5/2006
Inactive
Dairyland Insurance Company
301370
Agent - Casualty
2/13/2003
5/23/2005
Inactive
Dental Concern Inc. (The)
301641
Agent - Health
3/21/2009
6/18/2009
Inactive
Employers Mutual Casualty Company
300202
Agent - Casualty
3/16/2009
6/18/2009
Inactive
Employers Mutual Casualty Company
300202
Agent - Property
3/16/2009
6/18/2009
Inactive
Encompass Insurance Company of America
556578
Agent - Casualty
1/26/2004
3/21/2006
Inactive
Encompass Insurance Company of America
556578
Agent - Property
1/26/2004
3/21/2006
Inactive
Everlake Life Insurance Company
300873
Agent - Health
5/22/2007
10/19/2007
Inactive
Everlake Life Insurance Company
300873
Agent - Life
5/22/2007
10/19/2007
Inactive
First National Insurance Company of America
301690
Agent - Casualty
10/7/2008
6/18/2009
Inactive
First National Insurance Company of America
301690
Agent - Property
10/7/2008
6/18/2009
Inactive
Foremost Insurance Company Grand Rapids, Michigan
301027
Agent - Casualty
1/31/2014
8/7/2014
Inactive
Foremost Insurance Company Grand Rapids, Michigan
301027
Agent - Property
1/31/2014
8/7/2014
Inactive
Fortitude Life Insurance & Annuity Company
301503
Agent - Health
4/19/2007
6/18/2009
Inactive
Fortitude Life Insurance & Annuity Company
301503
Agent - Life
4/19/2007
6/18/2009
Inactive
Fortitude Life Insurance & Annuity Company
301503
Agent - Variable Life and Variable Annuities
4/19/2007
6/18/2009
Inactive
General Insurance Company of America
300261
Agent - Casualty
10/7/2008
6/18/2009
Inactive
General Insurance Company of America
300261
Agent - Property
10/7/2008
6/18/2009
Inactive
Genworth Life Insurance Company
300623
Agent - Health
5/24/2006
6/18/2009
Inactive
Genworth Life Insurance Company
300623
Agent - Life
5/24/2006
6/18/2009
Inactive
Glatfelter Insurance Company
301640
Agent - Casualty
7/19/2002
7/5/2006
Inactive
Glatfelter Insurance Company
301640
Agent - Property
7/19/2002
7/5/2006
Inactive
Golden Rule Insurance Company
301943
Agent - Health
4/20/2006
11/10/2008
Inactive
Golden Rule Insurance Company
301943
Agent - Life
4/20/2006
11/10/2008
Inactive
Granite State Insurance Company
300818
Agent - Casualty
6/29/2005
4/24/2006
Inactive
Granite State Insurance Company
300818
Agent - Property
6/29/2005
4/24/2006
Inactive
Hamilton Mutual Insurance Company
301111
Agent - Casualty
3/16/2009
6/18/2009
Inactive
Hamilton Mutual Insurance Company
301111
Agent - Property
3/16/2009
6/18/2009
Inactive
Hartford Accident and Indemnity Company
301917
Agent - Casualty
8/22/2002
3/13/2006
Inactive
Hartford Accident and Indemnity Company
301917
Agent - Property
8/22/2002
3/13/2006
Inactive
Hartford Casualty Insurance Company
301332
Agent - Casualty
8/22/2002
3/13/2006
Inactive
Hartford Casualty Insurance Company
301332
Agent - Property
8/22/2002
3/13/2006
Inactive
Hartford Fire Insurance Company
300628
Agent - Casualty
8/22/2002
3/13/2006
Inactive
Hartford Fire Insurance Company
300628
Agent - Property
8/22/2002
3/13/2006
Inactive
Hartford Insurance Company of the Midwest
301918
Agent - Casualty
8/22/2002
3/13/2006
Inactive
Hartford Insurance Company of the Midwest
301918
Agent - Property
8/22/2002
3/13/2006
Inactive
Hartford Underwriters Insurance Company
301064
Agent - Casualty
8/22/2002
3/13/2006
Inactive
Hartford Underwriters Insurance Company
301064
Agent - Property
8/22/2002
3/13/2006
Inactive
Humana Health Plan, Inc.
300142
Agent - Health
3/20/2009
6/18/2009
Inactive
Humana Insurance Company
301104
Agent - Health
2/20/2007
6/18/2009
Inactive
Humana Insurance Company
301104
Agent - Life
2/20/2007
6/18/2009
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Health
2/20/2007
6/18/2009
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Life
2/20/2007
6/18/2009
Inactive
HumanaDental Insurance Company
301457
Agent - Health
2/20/2007
6/18/2009
Inactive
HumanaDental Insurance Company
301457
Agent - Life
2/20/2007
6/18/2009
Inactive
Indiana Insurance Company
301909
Agent - Casualty
7/2/2002
7/5/2006
Inactive
Indiana Insurance Company
301909
Agent - Property
7/2/2002
7/5/2006
Inactive
Kansas City Fire and Marine Insurance Company
301936
Agent - Casualty
8/19/2002
12/20/2004
Inactive
Kansas City Fire and Marine Insurance Company
301936
Agent - Property
8/19/2002
12/20/2004
Inactive
Kentucky Farm Bureau Mutual Insurance Company
300570
Agent - Casualty
6/30/2015
3/28/2016
Inactive
Kentucky Farm Bureau Mutual Insurance Company
300570
Agent - Health
6/30/2015
3/28/2016
Inactive
Kentucky Farm Bureau Mutual Insurance Company
300570
Agent - Property
6/30/2015
3/28/2016
Inactive
Lincoln Benefit Life Company
301110
Agent - Health
5/22/2007
10/19/2007
Inactive
Lincoln Benefit Life Company
301110
Agent - Life
5/22/2007
10/19/2007
Inactive
Lincoln Benefit Life Company
301110
Agent - Variable Life and Variable Annuities
4/11/2007
10/19/2007
Inactive
Lumbermens Mutual Casualty Company
301119
Agent - Casualty
10/2/2002
5/31/2003
Inactive
Lumbermens Mutual Casualty Company
301119
Agent - Property
10/2/2002
5/31/2003
Inactive
Maryland Casualty Company
301719
Agent - Casualty
7/19/2002
7/5/2006
Inactive
Maryland Casualty Company
301719
Agent - Property
7/19/2002
7/5/2006
Inactive
MedAmerica Insurance Company
301568
Agent - Health
1/5/2007
6/18/2009
Inactive
NYLIFE Insurance Company of Arizona
301642
Agent - Health
8/10/2007
8/18/2008
Inactive
NYLIFE Insurance Company of Arizona
301642
Agent - Life
8/10/2007
8/18/2008
Inactive
Netherlands Insurance Company (The)
300339
Agent - Casualty
9/20/2002
7/5/2006
Inactive
Netherlands Insurance Company (The)
300339
Agent - Property
9/20/2002
7/5/2006
Inactive
New York Life Insurance Company
300431
Agent - Health
8/10/2007
8/18/2008
Inactive
New York Life Insurance Company
300431
Agent - Life
8/10/2007
8/18/2008
Inactive
New York Life Insurance and Annuity Corporation
300726
Agent - Health
8/10/2007
8/18/2008
Inactive
New York Life Insurance and Annuity Corporation
300726
Agent - Life
8/10/2007
8/18/2008
Inactive
New York Life Insurance and Annuity Corporation
300726
Agent - Variable Life and Variable Annuities
8/10/2007
8/18/2008
Inactive
Northern Insurance Company of New York
301317
Agent - Casualty
7/19/2002
7/5/2006
Inactive
Northern Insurance Company of New York
301317
Agent - Property
7/19/2002
7/5/2006
Inactive
Ohio Casualty Insurance Company
301492
Agent - Casualty
11/7/2007
6/18/2009
Inactive
Ohio Casualty Insurance Company
301492
Agent - Property
11/7/2007
6/18/2009
Inactive
Omni Indemnity Company
301456
Agent - Casualty
8/22/2002
3/13/2006
Inactive
Omni Indemnity Company
301456
Agent - Property
8/22/2002
3/13/2006
Inactive
Peerless Insurance Company
301910
Agent - Casualty
9/20/2002
7/5/2006
Inactive
Peerless Insurance Company
301910
Agent - Property
9/20/2002
7/5/2006
Inactive
Principal Life Insurance Company
300129
Agent - Health
5/17/2006
7/5/2006
Inactive
Principal Life Insurance Company
300129
Agent - Life
5/17/2006
7/5/2006
Inactive
ProAssurance Casualty Company
300928
Agent - Casualty
5/13/2005
7/5/2006
Inactive
Prudential Insurance Company of America
300784
Agent - Health
5/24/2006
6/18/2009
Inactive
Prudential Insurance Company of America
300784
Agent - Life
5/24/2006
6/18/2009
Inactive
Prudential Insurance Company of America
300784
Agent - Variable Life and Variable Annuities
10/19/2007
6/18/2009
Inactive
SAFECO Insurance Company of America
300159
Agent - Casualty
10/7/2008
6/18/2009
Inactive
SAFECO Insurance Company of America
300159
Agent - Property
10/7/2008
6/18/2009
Inactive
SAFECO Insurance Company of Illinois
301350
Agent - Casualty
10/7/2008
6/18/2009
Inactive
SAFECO Insurance Company of Illinois
301350
Agent - Property
10/7/2008
6/18/2009
Inactive
Sentinel Insurance Company, Limited
501696
Agent - Casualty
1/17/2005
3/13/2006
Inactive
Sentinel Insurance Company, Limited
501696
Agent - Property
1/17/2005
3/13/2006
Denied
Shelter Life Insurance Company
300391
Agent - Health
Denied
Shelter Life Insurance Company
300391
Agent - Life
Inactive
Shelter Mutual Insurance Company
301870
Agent - Casualty
12/11/2001
3/6/2002
Inactive
Shelter Mutual Insurance Company
301870
Agent - Property
11/13/2001
3/6/2002
Inactive
Southern Farm Bureau Life Insurance Company
300909
Agent - Health
7/6/2015
3/28/2016
Inactive
Southern Farm Bureau Life Insurance Company
300909
Agent - Life
7/6/2015
3/28/2016
Inactive
State Automobile Mutual Insurance Company
301824
Agent - Casualty
12/17/2013
1/1/2015
Inactive
State Automobile Mutual Insurance Company
301824
Agent - Property
12/17/2013
1/1/2015
Inactive
Talcott Resolution Life Insurance Company
301759
Agent - Health
12/10/2007
6/18/2009
Inactive
Talcott Resolution Life Insurance Company
301759
Agent - Life
12/10/2007
6/18/2009
Inactive
Talcott Resolution Life Insurance Company
301759
Agent - Variable Life and Variable Annuities
12/10/2007
6/18/2009
Inactive
Talcott Resolution Life and Annuity Insurance Company
300932
Agent - Health
12/10/2007
6/18/2009
Inactive
Talcott Resolution Life and Annuity Insurance Company
300932
Agent - Life
12/10/2007
6/18/2009
Inactive
Talcott Resolution Life and Annuity Insurance Company
300932
Agent - Variable Life and Variable Annuities
12/10/2007
6/18/2009
Inactive
Travelers Indemnity Company (The)
301855
Agent - Casualty
2/15/2005
7/5/2006
Inactive
Travelers Indemnity Company (The)
301855
Agent - Property
2/15/2005
7/5/2006
Inactive
Trumbull Insurance Company
300242
Agent - Casualty
8/22/2002
3/13/2006
Inactive
Trumbull Insurance Company
300242
Agent - Property
8/22/2002
3/13/2006
Inactive
Twin City Fire Insurance Company
300721
Agent - Casualty
8/22/2002
3/13/2006
Inactive
Twin City Fire Insurance Company
300721
Agent - Property
8/22/2002
3/13/2006
Inactive
Unitrin Auto and Home Insurance Company
301538
Agent - Casualty
9/7/2004
7/5/2006
Inactive
Unitrin Auto and Home Insurance Company
301538
Agent - Property
9/7/2004
7/5/2006
Inactive
Unitrin Preferred Insurance Company
502869
Agent - Casualty
9/7/2004
7/5/2006
Inactive
Unitrin Preferred Insurance Company
502869
Agent - Property
9/7/2004
7/5/2006
Inactive
Westfield Insurance Company
301950
Agent - Casualty
1/15/2014
7/22/2014
Inactive
Westfield Insurance Company
301950
Agent - Property
1/15/2014
7/22/2014
Inactive
301729
Agent - Casualty
10/2/2002
5/31/2003
Inactive
301729
Agent - Property
10/2/2002
5/31/2003
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Burckhard-Weaver Insurance Agency Inc
549387
Agent - Property
8/21/2002
3/11/2005
Inactive
Burckhard-Weaver Insurance Agency Inc
549387
Agent - Casualty
8/21/2002
3/11/2005
Inactive
Designated Agent Company Inc.
681257
Agent - Health
10/29/2015
3/28/2016
Inactive
Geny Insurance Group, LLC
800421
Agent - Property
12/17/2013
7/18/2014
Inactive
Geny Insurance Group, LLC
800421
Agent - Casualty
12/17/2013
7/18/2014
Inactive
Kentucky Farm Bureau Insurance Agency LLC
399619
Agent - Health
6/30/2015
3/23/2016
Inactive
Kentucky Farm Bureau Insurance Agency LLC
399619
Agent - Life
7/6/2015
3/23/2016
Inactive
Kentucky Farm Bureau Insurance Agency LLC
399619
Agent - Property
6/30/2015
3/23/2016
Inactive
Kentucky Farm Bureau Insurance Agency LLC
399619
Agent - Casualty
6/30/2015
3/23/2016
Inactive
NYLIFE Securities, LLC
645470
Agent - Variable Life and Variable Annuities
3/4/2008
8/14/2008
Inactive
Neace Lukens, Inc.
398909
Agent - Property
2/18/2005
6/29/2005
Inactive
Neace Lukens, Inc.
398909
Agent - Casualty
2/18/2005
6/29/2005
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