DEPARTMENT OF INSURANCE

Affiliations

Name	Hennessey, Chad Alan	DOIID	518424	NAIC NPN	7215705

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Health	6/30/2006	8/31/2026
Active	Resident	Agent	Life	5/13/2003	8/31/2026
Active	Resident	Agent	Casualty	6/20/2001	8/31/2026
Active	Resident	Agent	Property	2/12/2001	8/31/2026
Active	Resident	Surplus Lines Broker	Not Applicable	5/13/2019	8/31/2026
* 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	1st Choice Advantage Insurance Company, Inc.	750782	Agent - Casualty	9/22/2011	10/1/2021
Active	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	12/15/2022
Active	ACUITY, A Mutual Insurance Company	300095	Agent - Property	12/15/2022
Inactive	Addison Insurance Company	874810	Agent - Casualty	4/28/2017	9/7/2021
Inactive	Addison Insurance Company	874810	Agent - Property	4/28/2017	9/7/2021
Active	Allied Eastern Indemnity Company	683842	Agent - Casualty	10/31/2022
Active	American Economy Insurance Company	300315	Agent - Casualty	6/1/2022
Active	American Economy Insurance Company	300315	Agent - Property	6/1/2022
Active	American Fire and Casualty Company	300567	Agent - Casualty	4/27/2004
Active	American Fire and Casualty Company	300567	Agent - Property	4/27/2004
Inactive	American General Life Insurance Company	301585	Agent - Health	6/26/2014	8/9/2024
Inactive	American General Life Insurance Company	301585	Agent - Life	6/26/2014	8/9/2024
Active	American National Insurance Company	301861	Agent - Life	7/10/2019
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Health	9/7/2012	11/30/2016
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Life	9/7/2012	11/30/2016
Inactive	Association Casualty Insurance Company	650779	Agent - Casualty	9/19/2017	7/12/2018
Inactive	Association Casualty Insurance Company	650779	Agent - Property	9/19/2017	7/12/2018
Inactive	Assurance Company of America	300432	Agent - Casualty	6/20/2001	12/16/2014
Inactive	Assurance Company of America	300432	Agent - Property	3/15/2001	12/16/2014
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Casualty	3/3/2009	9/21/2016
Inactive	Auto Club Property-Casualty Insurance Company	650781	Agent - Property	3/3/2009	9/21/2016
Active	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	6/20/2001
Active	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	5/3/2001
Inactive	Banner Life Insurance Company	301696	Agent - Life	7/12/2005	5/27/2024
Active	Bridgefield Casualty Insurance Company	500013	Agent - Casualty	8/15/2012
Active	Brighthouse Life Insurance Company	301829	Agent - Health	11/14/2014
Active	Brighthouse Life Insurance Company	301829	Agent - Life	11/14/2014
Active	Bristol West Insurance Company	301655	Agent - Casualty	11/24/2008
Active	Bristol West Insurance Company	301655	Agent - Property	11/24/2008
Active	BusinessFirst Insurance Company	722488	Agent - Casualty	5/2/2024
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	6/20/2001	12/3/2014
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	5/3/2001	12/3/2014
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	3/25/2004	4/1/2007
Active	Cincinnati Casualty Company (The)	300308	Agent - Casualty	1/6/2023
Active	Cincinnati Casualty Company (The)	300308	Agent - Property	1/6/2023
Active	Cincinnati Indemnity Company (The)	301566	Agent - Casualty	1/6/2023
Active	Cincinnati Indemnity Company (The)	301566	Agent - Property	1/6/2023
Active	Cincinnati Insurance Company	301298	Agent - Casualty	1/6/2023
Active	Cincinnati Insurance Company	301298	Agent - Property	1/6/2023
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	2/21/2020
Active	ClearPath Insurance Company	979815	Agent - Casualty	2/29/2024
Inactive	Columbia Mutual Insurance Company	301295	Agent - Casualty	9/19/2017	7/12/2018
Inactive	Columbia Mutual Insurance Company	301295	Agent - Property	9/19/2017	7/12/2018
Inactive	Columbia National Insurance Company	751543	Agent - Casualty	1/15/2018	7/12/2018
Inactive	Columbia National Insurance Company	751543	Agent - Property	1/15/2018	7/12/2018
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	6/20/2001	7/30/2009
Inactive	Consolidated Insurance Company	300943	Agent - Property	3/26/2001	7/30/2009
Inactive	Country Mutual Insurance Company	301024	Agent - Casualty	1/1/2017	6/13/2019
Inactive	Country Mutual Insurance Company	301024	Agent - Property	1/1/2017	6/13/2019
Inactive	EMC National Life Company	300388	Agent - Health	2/6/2014	5/10/2018
Inactive	EMC National Life Company	300388	Agent - Life	2/6/2014	5/10/2018
Inactive	EMCASCO Insurance Company	842790	Agent - Casualty	2/12/2015	2/15/2018
Inactive	EMCASCO Insurance Company	842790	Agent - Property	2/12/2015	2/15/2018
Active	Eastern Advantage Assurance Company	692390	Agent - Casualty	10/31/2022
Active	Eastern Alliance Insurance Company	683841	Agent - Casualty	10/31/2022
Inactive	Employers Mutual Casualty Company	300202	Agent - Casualty	2/6/2014	2/15/2018
Inactive	Employers Mutual Casualty Company	300202	Agent - Property	2/6/2014	2/15/2018
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	11/9/2012	10/3/2024
Inactive	Encompass Indemnity Company	546376	Agent - Property	11/9/2012	10/3/2024
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	11/9/2012	10/3/2024
Inactive	Encompass Insurance Company of America	556578	Agent - Property	11/9/2012	10/3/2024
Inactive	Encova Life Insurance Company	301818	Agent - Life	12/22/2003	1/14/2015
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Health	1/23/2012	12/28/2018
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	1/23/2012	12/28/2018
Inactive	Everett Cash Mutual Insurance Company	750768	Agent - Casualty	9/22/2011	10/1/2021
Inactive	Everett Cash Mutual Insurance Company	750768	Agent - Property	9/22/2011	10/1/2021
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	9/16/2003	8/21/2012
Inactive	Farmers Insurance Exchange	300336	Agent - Property	9/16/2003	8/21/2012
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	2/2/2017	2/24/2024
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	2/2/2017	2/24/2024
Inactive	First Colony Life Insurance Company	301179	Agent - Life	6/22/2004	1/1/2007
Inactive	First National Insurance Company of America	301690	Agent - Casualty	10/7/2008	10/15/2021
Inactive	First National Insurance Company of America	301690	Agent - Property	10/7/2008	10/15/2021
Inactive	General Insurance Company of America	300261	Agent - Casualty	10/7/2008	10/15/2021
Inactive	General Insurance Company of America	300261	Agent - Property	10/7/2008	10/15/2021
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	4/25/2009	12/7/2012
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	3/13/2014	12/14/2016
Inactive	Glatfelter Insurance Company	301640	Agent - Casualty	6/20/2001	11/30/2007
Inactive	Glatfelter Insurance Company	301640	Agent - Property	3/15/2001	11/30/2007
Inactive	GuideOne Elite Insurance Company	300490	Agent - Casualty	3/1/2013	11/3/2021
Inactive	GuideOne Elite Insurance Company	300490	Agent - Property	3/1/2013	11/3/2021
Inactive	GuideOne Insurance Company	301794	Agent - Casualty	3/1/2013	11/3/2021
Inactive	GuideOne Insurance Company	301794	Agent - Property	3/1/2013	11/3/2021
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Casualty	3/8/2016	11/3/2021
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Property	3/8/2016	11/3/2021
Inactive	Hamilton Mutual Insurance Company	301111	Agent - Casualty	2/6/2014	12/15/2017
Inactive	Hamilton Mutual Insurance Company	301111	Agent - Property	2/6/2014	12/15/2017
Active	Hartford Accident and Indemnity Company	301917	Agent - Casualty	6/15/2020
Active	Hartford Accident and Indemnity Company	301917	Agent - Property	6/15/2020
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	2/6/2015	8/18/2017
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	2/6/2015	8/18/2017
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	12/15/2005	11/16/2009
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	12/15/2005	11/16/2009
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	12/15/2005	11/16/2009
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	12/15/2005	11/16/2009
Active	Hartford Underwriters Insurance Company	301064	Agent - Casualty	4/29/2021
Active	Hartford Underwriters Insurance Company	301064	Agent - Property	4/29/2021
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/26/2008	9/8/2010
Inactive	Humana Insurance Company	301104	Agent - Health	3/26/2008	9/8/2010
Inactive	Humana Insurance Company	301104	Agent - Life	3/26/2008	9/8/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/26/2008	9/8/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/26/2008	9/8/2010
Inactive	Indiana Insurance Company	301909	Agent - Casualty	6/20/2001	7/30/2009
Inactive	Indiana Insurance Company	301909	Agent - Property	3/26/2001	7/30/2009
Inactive	Infinity Standard Insurance Company	301643	Agent - Casualty	6/20/2001	10/18/2004
Inactive	Infinity Standard Insurance Company	301643	Agent - Property	4/16/2001	10/18/2004
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	10/9/2019	6/23/2022
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	10/9/2019	6/23/2022
Active	Keystone National Insurance Company	745173	Agent - Casualty	4/17/2020
Active	Keystone National Insurance Company	745173	Agent - Property	4/17/2020
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	9/7/2017	10/30/2023
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	9/7/2017	10/30/2023
Active	MICO Insurance Company	301664	Agent - Casualty	9/26/2023
Active	MICO Insurance Company	301664	Agent - Property	9/26/2023
Inactive	Maryland Casualty Company	301719	Agent - Property	3/15/2001	12/16/2014
Active	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	11/22/2021
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	11/17/2008	11/14/2014
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	11/17/2008	11/14/2014
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	11/22/2013	4/27/2018
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	11/22/2013	4/27/2018
Inactive	Middlesex Mutual Assurance Company	569442	Agent - Casualty	8/1/2008	12/31/2016
Inactive	Middlesex Mutual Assurance Company	569442	Agent - Property	8/1/2008	12/31/2016
Active	Milbank Insurance Company	925185	Agent - Casualty	2/13/2020
Active	Milbank Insurance Company	925185	Agent - Property	2/13/2020
Active	Motorists Commercial Mutual Insurance Company	301941	Agent - Casualty	4/10/2019
Active	Motorists Mutual Insurance Company	300963	Agent - Casualty	2/25/2019
Active	Motorists Mutual Insurance Company	300963	Agent - Property	2/25/2019
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	6/20/2001	7/30/2009
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	3/26/2001	7/30/2009
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	5/29/2016	4/23/2019
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	6/20/2001	12/16/2014
Inactive	Northern Insurance Company of New York	301317	Agent - Property	3/16/2001	12/16/2014
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	8/8/2002
Active	Ohio Casualty Insurance Company	301492	Agent - Property	8/8/2002
Active	Ohio Security Insurance Company	300622	Agent - Casualty	4/27/2004
Active	Ohio Security Insurance Company	300622	Agent - Property	4/27/2004
Inactive	Old Guard Insurance Company	533854	Agent - Casualty	6/2/2021	6/11/2021
Inactive	Old Guard Insurance Company	533854	Agent - Property	6/2/2021	6/11/2021
Inactive	PHL Variable Insurance Company	300525	Agent - Life	8/22/2011	11/11/2016
Active	Pacific Life Insurance Company	301848	Agent - Health	5/31/2024
Active	Pacific Life Insurance Company	301848	Agent - Life	5/31/2024
Active	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/8/2007
Active	Peerless Indemnity Insurance Company	571682	Agent - Property	9/8/2007
Inactive	Peerless Insurance Company	301910	Agent - Casualty	6/20/2001	7/30/2009
Inactive	Peerless Insurance Company	301910	Agent - Property	3/26/2001	7/30/2009
Active	Philadelphia Indemnity Insurance Company	301221	Agent - Casualty	3/29/2010
Active	Philadelphia Indemnity Insurance Company	301221	Agent - Property	3/29/2010
Active	Plaza Insurance Company	300748	Agent - Casualty	4/28/2022
Active	Plaza Insurance Company	300748	Agent - Property	4/28/2022
Active	Principal Life Insurance Company	300129	Agent - Health	6/25/2009
Active	Principal Life Insurance Company	300129	Agent - Life	6/25/2009
Active	Principal National Life Insurance Company	301926	Agent - Life	1/25/2012
Active	Privilege Underwriters Reciprocal Exchange	769657	Agent - Casualty	10/12/2023
Active	Privilege Underwriters Reciprocal Exchange	769657	Agent - Property	10/12/2023
Active	Property and Casualty Insurance Company of Hartford	301409	Agent - Casualty	7/3/2022
Active	Property and Casualty Insurance Company of Hartford	301409	Agent - Property	7/3/2022
Inactive	Protective Insurance Company	301117	Agent - Casualty	12/6/2017	4/6/2018
Inactive	Protective Insurance Company	301117	Agent - Property	12/6/2017	4/6/2018
Active	Protective Life Insurance Company	300638	Agent - Life	12/12/2012
Inactive	Pruco Life Insurance Company	300954	Agent - Health	9/12/2006	12/21/2022
Active	Pruco Life Insurance Company	300954	Agent - Life	4/25/2023
Denied	Reassure America Life Insurance Company	301902	Agent - Health
Denied	Reassure America Life Insurance Company	301902	Agent - Life
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	11/7/2006	2/27/2016
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	10/7/2008
Active	SAFECO Insurance Company of America	300159	Agent - Property	10/7/2008
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	6/7/2022
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	6/7/2022
Inactive	Sagamore Insurance Company	300942	Agent - Casualty	11/3/2016	4/6/2018
Inactive	Sagamore Insurance Company	300942	Agent - Property	11/3/2016	4/6/2018
Active	Selective Insurance Company of America	500018	Agent - Casualty	9/29/2014
Active	Selective Insurance Company of America	500018	Agent - Property	9/29/2014
Active	Selective Insurance Company of South Carolina	500012	Agent - Casualty	9/29/2014
Active	Selective Insurance Company of South Carolina	500012	Agent - Property	9/29/2014
Active	Selective Insurance Company of the Southeast	300381	Agent - Casualty	9/29/2014
Active	Selective Insurance Company of the Southeast	300381	Agent - Property	9/29/2014
Active	Sentinel Insurance Company, Limited	501696	Agent - Casualty	12/13/2022
Active	Sentinel Insurance Company, Limited	501696	Agent - Property	12/13/2022
Active	Standard Fire Insurance Company (The)	301068	Agent - Casualty	6/20/2001
Active	Standard Fire Insurance Company (The)	301068	Agent - Property	5/3/2001
Inactive	Standard Insurance Company	300185	Agent - Health	2/1/2008	12/5/2022
Inactive	Standard Insurance Company	300185	Agent - Life	2/1/2008	12/5/2022
Active	State Auto Property & Casualty Insurance Company	301953	Agent - Casualty	2/13/2020
Active	State Auto Property & Casualty Insurance Company	301953	Agent - Property	2/13/2020
Active	State Automobile Mutual Insurance Company	301824	Agent - Casualty	4/21/2023
Active	State Automobile Mutual Insurance Company	301824	Agent - Property	4/21/2023
Active	Symetra Life Insurance Company	301691	Agent - Health	2/28/2022
Active	Symetra Life Insurance Company	301691	Agent - Life	2/28/2022
Active	The Phoenix Insurance Company	301502	Agent - Casualty	6/20/2001
Active	The Phoenix Insurance Company	301502	Agent - Property	5/3/2001
Inactive	The Savings Bank Mutual Life Insurance Company of Massachusetts	690290	Agent - Life	8/30/2013	11/29/2018
Active	Transamerica Life Insurance Company	300571	Agent - Health	6/1/2021
Active	Transamerica Life Insurance Company	300571	Agent - Life	6/1/2021
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	4/16/2008	10/1/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	4/16/2008	10/1/2008
Inactive	TravCo Insurance Company	301828	Agent - Casualty	6/20/2001	12/5/2013
Inactive	TravCo Insurance Company	301828	Agent - Property	5/3/2001	12/5/2013
Inactive	Travelers Casualty Company of Connecticut	301505	Agent - Casualty	9/3/2002	12/5/2013
Inactive	Travelers Casualty Company of Connecticut	301505	Agent - Property	9/3/2002	12/5/2013
Active	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	7/18/2005
Active	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	7/18/2005
Active	Travelers Indemnity Company (The)	301855	Agent - Casualty	6/20/2001
Active	Travelers Indemnity Company (The)	301855	Agent - Property	5/3/2001
Inactive	Travelers Property Casualty Insurance Company	301508	Agent - Casualty	9/3/2002	12/5/2013
Inactive	Travelers Property Casualty Insurance Company	301508	Agent - Property	9/3/2002	12/5/2013
Inactive	Truck Insurance Exchange	300335	Agent - Casualty	6/1/2007	8/21/2012
Inactive	Truck Insurance Exchange	300335	Agent - Property	6/1/2007	8/21/2012
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	12/15/2005	11/16/2009
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	12/15/2005	11/16/2009
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	10/10/2005	10/19/2007
Inactive	Union Insurance Company of Providence	842791	Agent - Casualty	2/12/2015	2/15/2018
Inactive	Union Insurance Company of Providence	842791	Agent - Property	2/12/2015	2/15/2018
Inactive	United Fire & Casualty Company	301374	Agent - Casualty	4/28/2017	9/7/2021
Inactive	United Fire & Casualty Company	301374	Agent - Property	4/28/2017	9/7/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	1/15/2016	11/22/2016
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	1/15/2016	11/22/2016
Active	Unitrin Auto and Home Insurance Company	301538	Agent - Casualty	4/8/2005
Active	Unitrin Auto and Home Insurance Company	301538	Agent - Property	4/8/2005
Inactive	Unitrin Preferred Insurance Company	502869	Agent - Casualty	4/8/2005	12/2/2013
Inactive	Unitrin Preferred Insurance Company	502869	Agent - Property	4/8/2005	12/2/2013
Active	Unitrin Safeguard Insurance Company	301371	Agent - Casualty	10/11/2018
Active	Unitrin Safeguard Insurance Company	301371	Agent - Property	10/11/2018
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Health	8/22/2007	6/6/2008
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	8/22/2007	6/6/2008
Active	West American Insurance Company	301112	Agent - Casualty	4/27/2004
Active	West American Insurance Company	301112	Agent - Property	4/27/2004
Inactive	West Bend Insurance Company	672974	Agent - Casualty	10/25/2011	12/27/2017
Inactive	West Bend Insurance Company	672974	Agent - Property	10/25/2011	12/27/2017
Inactive	West Coast Life Insurance Company	301607	Agent - Life	1/22/2004	11/16/2011
Inactive	Western National Life Insurance Company	300461	Agent - Life	7/15/2004	11/21/2007
Inactive	Westfield Champion Insurance Company	1054839	Agent - Casualty	6/2/2021	6/11/2021
Inactive	Westfield Champion Insurance Company	1054839	Agent - Property	6/2/2021	6/11/2021
Active	Westfield Insurance Company	301950	Agent - Casualty	10/19/2020
Active	Westfield Insurance Company	301950	Agent - Property	10/19/2020
Inactive	Westfield Premier Insurance Company	1055055	Agent - Casualty	6/2/2021	6/11/2021
Inactive	Westfield Premier Insurance Company	1055055	Agent - Property	6/2/2021	6/11/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Casualty	6/2/2021	6/11/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Property	6/2/2021	6/11/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Casualty	6/2/2021	6/11/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Property	6/2/2021	6/11/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Insuramax Inc	400061	Agent - Property	10/10/2001
Active	Insuramax Inc	400061	Agent - Casualty	10/10/2001
Active	Insuramax Inc	400061	Agent - Life	8/11/2003
Active	Insuramax Inc	400061	Agent - Health	9/18/2008
Active	Insuramax Inc	400061	Surplus Lines Broker - Not Applicable	5/16/2019
Active	Keystone Ins & Benefits Group LLC	716920	Agent - Life	10/14/2015
Active	Keystone Ins & Benefits Group LLC	716920	Agent - Health	10/14/2015