DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, John Thomas	DOIID	562374	NAIC NPN	7541420

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Variable Life and Variable Annuities	10/28/2003	6/30/2026
Active	Resident	Agent	Casualty	12/13/2005	6/30/2026
Active	Resident	Agent	Life	1/14/2003	6/30/2026
Active	Resident	Agent	Health	1/14/2003	6/30/2026
Active	Resident	Agent	Property	12/13/2005	6/30/2026
* 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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2024	06/30/2024	06/18/2024	06/18/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AMCO Insurance Company	300204	Agent - Casualty	9/19/2022	3/25/2024
Inactive	AMCO Insurance Company	300204	Agent - Property	9/19/2022	3/25/2024
Active	Aetna Health Inc. (PA)	660717	Agent - Health	10/17/2018
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	6/24/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	10/17/2018
Active	Aetna Life Insurance Company	301140	Agent - Life	10/17/2018
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	8/18/2020
Active	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	8/18/2020
Inactive	Allied Insurance Company of America	793586	Agent - Casualty	2/11/2020	3/25/2024
Inactive	Allied Insurance Company of America	793586	Agent - Property	2/11/2020	3/25/2024
Inactive	American Hallmark Insurance Company of Texas	709267	Agent - Casualty	9/25/2015	2/6/2024
Inactive	American Hallmark Insurance Company of Texas	709267	Agent - Property	9/25/2015	2/6/2024
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/29/2021
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Active	Anthem Life Insurance Company	301209	Agent - Health	2/1/2006
Active	Anthem Life Insurance Company	301209	Agent - Life	2/1/2006
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	10/18/2018
Inactive	Assurity Life Insurance Company	301099	Agent - Health	1/23/2004	3/15/2018
Inactive	Assurity Life Insurance Company	301099	Agent - Life	1/23/2004	3/15/2018
Inactive	Athene Annuity & Life Assurance Company of New York	300724	Agent - Life	8/16/2012	5/8/2013
Inactive	Athene Annuity and Life Company	301893	Agent - Life	12/13/2010	4/14/2013
Inactive	Banner Life Insurance Company	301696	Agent - Life	6/28/2004	1/29/2013
Active	Bristol West Insurance Company	301655	Agent - Casualty	3/20/2017
Active	Bristol West Insurance Company	301655	Agent - Property	3/20/2017
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	11/6/2019
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	12/15/2009	8/31/2011
Active	CompBenefits Insurance Company	301864	Agent - Health	12/30/2020
Inactive	CompBenefits Insurance Company	301864	Agent - Life	12/15/2009	8/31/2011
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/16/2021
Active	Dairyland Insurance Company	301370	Agent - Casualty	2/27/2017
Active	Dairyland Insurance Company	301370	Agent - Property	2/27/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/5/2018	12/19/2019
Inactive	Everly Life Insurance Company	561641	Agent - Life	11/11/2016	2/10/2017
Active	First Health Life & Health Insurance Company	301735	Agent - Health	10/17/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/8/2010	12/20/2023
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/8/2010	12/20/2023
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	5/19/2008	12/7/2012
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	5/19/2008	12/7/2012
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Health	11/16/2018	9/22/2022
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	11/16/2018	9/22/2022
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/18/2018
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/18/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/6/2020	12/15/2020
Active	Humana Insurance Company	301104	Agent - Health	10/18/2018
Active	Humana Insurance Company	301104	Agent - Life	10/18/2018
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	4/6/2020
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	4/6/2020
Active	Humana Medical Plan, Inc.	801568	Agent - Health	10/18/2018
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/18/2018
Inactive	John Alden Life Insurance Company	300573	Agent - Health	9/10/2004	12/29/2010
Inactive	John Alden Life Insurance Company	300573	Agent - Life	9/10/2004	12/29/2010
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	12/5/2003	8/18/2006
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	12/5/2003	8/18/2006
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	11/27/2023
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Variable Life and Variable Annuities	11/27/2023
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Life	12/5/2003	8/18/2006
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/15/2009	8/31/2011
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/15/2009	8/31/2011
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	1/6/2014	10/29/2015
Inactive	Kentucky National Insurance Company	301625	Agent - Casualty	1/30/2015	12/9/2015
Inactive	Kentucky National Insurance Company	301625	Agent - Property	1/30/2015	12/9/2015
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	11/18/2009	7/14/2015
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	11/18/2009	7/14/2015
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Variable Life and Variable Annuities	11/18/2009	7/14/2015
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	4/14/2009	6/20/2014
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	4/14/2009	6/20/2014
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	8/4/2009	6/20/2014
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	8/4/2009	6/20/2014
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	1/23/2003	8/14/2003
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Health	10/5/2004	1/7/2014
Inactive	Nassau Life Insurance Company of Texas	300872	Agent - Life	10/5/2004	1/7/2014
Inactive	Nationwide Agribusiness Insurance Company	301008	Agent - Casualty	6/1/2012	1/3/2023
Inactive	Nationwide Agribusiness Insurance Company	301008	Agent - Property	6/1/2012	1/3/2023
Inactive	Nationwide Assurance Company	300166	Agent - Casualty	12/21/2005	3/25/2024
Inactive	Nationwide General Insurance Company	300603	Agent - Casualty	12/21/2005	3/25/2024
Inactive	Nationwide General Insurance Company	300603	Agent - Property	12/21/2005	3/25/2024
Inactive	Nationwide Insurance Company of America	300333	Agent - Casualty	4/1/2011	3/25/2024
Inactive	Nationwide Insurance Company of America	300333	Agent - Property	4/1/2011	3/25/2024
Active	Nationwide Life Insurance Company	300495	Agent - Health	7/8/2003
Active	Nationwide Life Insurance Company	300495	Agent - Life	7/8/2003
Active	Nationwide Life Insurance Company	300495	Agent - Variable Life and Variable Annuities	9/14/2022
Active	Nationwide Life and Annuity Insurance Company	300714	Agent - Health	6/12/2019
Active	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	7/8/2003
Active	Nationwide Life and Annuity Insurance Company	300714	Agent - Variable Life and Variable Annuities	9/14/2022
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - Casualty	12/21/2005	1/1/2023
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - Property	12/21/2005	1/1/2023
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	12/21/2005	3/25/2024
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	12/21/2005	3/25/2024
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	12/21/2005	3/25/2024
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	12/21/2005	3/25/2024
Inactive	Omaha Insurance Company	751908	Agent - Health	11/1/2013	11/23/2015
Active	Progressive Casualty Insurance Company	300696	Agent - Casualty	8/9/2020
Active	Progressive Casualty Insurance Company	300696	Agent - Property	8/9/2020
Active	Protective Life Insurance Company	300638	Agent - Health	8/7/2019
Active	Protective Life Insurance Company	300638	Agent - Life	8/7/2019
Active	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities	8/7/2019
Inactive	Pruco Life Insurance Company	300954	Agent - Health	11/27/2006	12/22/2016
Inactive	Pruco Life Insurance Company	300954	Agent - Life	11/27/2006	12/22/2016
Active	SilverScript Insurance Company	663526	Agent - Health	8/23/2019
Inactive	State Life Insurance Company	301497	Agent - Health	3/15/2004	1/31/2007
Inactive	State Life Insurance Company	301497	Agent - Life	3/15/2004	1/31/2007
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	5/26/2010	3/15/2021
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	5/26/2010	3/15/2021
Active	United Financial Casualty Company	301886	Agent - Casualty	8/9/2020
Active	United Financial Casualty Company	301886	Agent - Property	8/9/2020
Inactive	United Home Life Insurance Company	300421	Agent - Life	3/1/2005	6/23/2008
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	3/30/2005	10/15/2007
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	3/30/2005	10/15/2007
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	2/7/2007	1/11/2018
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	2/7/2007	1/11/2018
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/21/2019	4/8/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/21/2019	4/8/2021
Inactive		300277	Agent - Life	4/20/2004	12/18/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	2/1/2006	6/21/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	2/1/2006	6/21/2008
Active	Dental Choice Agency Inc.	398085	Agent - Health	12/5/2019
Active	Designated Agent Company Inc.	681257	Agent - Health	6/28/2008
Active	Designated Agent Company Inc.	681257	Agent - Life	6/28/2008
Active	John Clark & Associates Inc	875617	Agent - Life	4/9/2020
Active	John Clark & Associates Inc	875617	Agent - Casualty	4/24/2015
Active	John Clark & Associates Inc	875617	Agent - Property	4/24/2015
Inactive	McGuire Insurance Agency, Inc.	502147	Agent - Health	12/30/2003	11/21/2023
Inactive	McGuire Insurance Agency, Inc.	502147	Agent - Life	12/30/2003	11/21/2023
Inactive	McGuire Insurance Agency, Inc.	502147	Agent - Variable Life and Variable Annuities	12/19/2005	11/21/2023
Inactive	Medlink Inc	400721	Agent - Health	7/28/2006	3/31/2024
Inactive	Medlink Inc	400721	Agent - Life	7/28/2006	3/31/2024
Inactive	NBS Insurance Agency Inc	515576	Agent - Casualty	5/14/2015	3/25/2024
Inactive	NBS Insurance Agency Inc	515576	Agent - Property	5/14/2015	3/25/2024