DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Karen Ann	DOIID	581214	NAIC NPN	3030704

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	11/28/2003	10/6/2014
Inactive	Non Resident	Agent	Health	11/28/2003	10/6/2014
* 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	CompBenefits Dental, Inc.	591692	Agent - Health	12/19/2011	10/6/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/19/2011	10/6/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/17/2014	10/6/2014
Inactive	Humana Insurance Company	301104	Agent - Health	12/19/2011	10/6/2014
Inactive	Humana Insurance Company	301104	Agent - Life	12/19/2011	10/6/2014
Inactive	HumanaDental Insurance Company	301457	Agent - Health	12/19/2011	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	12/19/2011	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/19/2011	10/6/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/19/2011	10/6/2014
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	1/10/2008	12/15/2014
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	1/10/2008	12/15/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CBIZ Benefits & Ins Services Inc	514101	Agent - Life	3/27/2014	8/5/2014
Inactive	CBIZ Benefits & Ins Services Inc	514101	Agent - Health	3/27/2014	8/5/2014