DEPARTMENT OF INSURANCE
Affiliations
NameBlock, Randall KeithDOIID616221NAIC NPN8599197
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
Pending Replacement CE ComplianceResidentAgentLife7/23/2007  
Pending Replacement CE ComplianceResidentAgentVariable Life and Variable Annuities7/23/2007  
Pending Replacement CE ComplianceResidentAgentHealth7/23/2007  
* 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
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202503/31/202503/11/202503/11/2025Yes
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
Pending ReplacementAllianz Life Insurance Company of North America301791Agent - Health2/29/2016 
Pending ReplacementAllianz Life Insurance Company of North America301791Agent - Life2/29/2016 
Pending ReplacementAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities2/29/2016 
InactiveAmerican General Life Insurance Company301585Agent - Health10/8/201412/23/2019
InactiveAmerican General Life Insurance Company301585Agent - Life10/8/201412/23/2019
InactiveAmerican General Life Insurance Company301585Agent - Variable Life and Variable Annuities10/8/201412/23/2019
Pending ReplacementAmerican National Insurance Company301861Agent - Life2/3/2022 
InactiveAssurity Life Insurance Company301099Agent - Health7/12/20063/31/2007
InactiveAssurity Life Insurance Company301099Agent - Life7/12/20063/31/2007
Pending ReplacementAthene Annuity and Life Company301893Agent - Life11/7/2017 
InactiveBanner Life Insurance Company301696Agent - Life9/26/20149/5/2017
Pending ReplacementBrighthouse Life Insurance Company301829Agent - Health10/7/2016 
Pending ReplacementBrighthouse Life Insurance Company301829Agent - Life10/7/2016 
InactiveChase Insurance Life and Annuity Company300518Agent - Life2/2/20064/1/2007
InactiveDelaware Life Insurance Company301256Agent - Life7/21/201612/21/2021
InactiveFirst Colony Life Insurance Company301179Agent - Health7/17/20061/1/2007
InactiveFirst Colony Life Insurance Company301179Agent - Life7/17/20061/1/2007
Pending ReplacementForethought Life Insurance Company301407Agent - Health5/16/2018 
Pending ReplacementForethought Life Insurance Company301407Agent - Life5/16/2018 
Pending ReplacementForethought Life Insurance Company301407Agent - Variable Life and Variable Annuities5/16/2018 
Pending ReplacementFortitude Life Insurance & Annuity Company301503Agent - Health8/3/2007 
Pending ReplacementFortitude Life Insurance & Annuity Company301503Agent - Life8/3/2007 
Pending ReplacementFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities8/3/2007 
InactiveGenworth Life Insurance Company300623Agent - Health1/8/201512/14/2016
InactiveGenworth Life Insurance Company300623Agent - Life1/8/201512/14/2016
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health8/25/20101/5/2015
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life8/25/20101/5/2015
Pending ReplacementJackson National Life Insurance Company300486Agent - Life11/15/2008 
Pending ReplacementJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities7/27/2007 
InactiveLincoln National Life Insurance Company (The)301382Agent - Health4/3/201910/26/2021
InactiveLincoln National Life Insurance Company (The)301382Agent - Life4/3/201910/26/2021
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities4/3/201910/26/2021
InactiveMassMutual Ascend Life Insurance Company300320Agent - Variable Life and Variable Annuities7/13/202211/15/2024
Pending ReplacementNationwide Life Insurance Company300495Agent - Health1/12/2011 
Pending ReplacementNationwide Life Insurance Company300495Agent - Life1/12/2011 
Pending ReplacementNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities1/12/2011 
Pending ReplacementNationwide Life and Annuity Insurance Company300714Agent - Health4/14/2015 
Pending ReplacementNationwide Life and Annuity Insurance Company300714Agent - Life4/14/2015 
Pending ReplacementNationwide Life and Annuity Insurance Company300714Agent - Variable Life and Variable Annuities4/14/2015 
Pending ReplacementNorth American Company for Life and Health Insurance300291Agent - Life1/27/2021 
Pending ReplacementPacific Life Insurance Company301848Agent - Life6/20/2013 
Pending ReplacementPacific Life Insurance Company301848Agent - Variable Life and Variable Annuities6/20/2013 
Pending ReplacementPrincipal National Life Insurance Company301926Agent - Life5/24/2017 
InactiveProtective Life Insurance Company300638Agent - Health6/25/202011/23/2023
InactiveProtective Life Insurance Company300638Agent - Life6/25/202011/23/2023
InactiveProtective Life Insurance Company300638Agent - Variable Life and Variable Annuities6/25/202011/23/2023
Pending ReplacementPruco Life Insurance Company300954Agent - Health2/22/2010 
Pending ReplacementPruco Life Insurance Company300954Agent - Life2/22/2010 
Pending ReplacementPruco Life Insurance Company300954Agent - Variable Life and Variable Annuities2/22/2010 
InactiveSecurity Life of Denver Insurance Company300648Agent - Health7/27/20167/5/2019
InactiveSecurity Life of Denver Insurance Company300648Agent - Life7/27/20167/5/2019
InactiveSecurity Life of Denver Insurance Company300648Agent - Variable Life and Variable Annuities7/27/20167/5/2019
InactiveTalcott Resolution Life Insurance Company301759Agent - Health10/20/20082/25/2013
InactiveTalcott Resolution Life Insurance Company301759Agent - Life10/20/20082/25/2013
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities10/20/20082/25/2013
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Health10/20/200811/16/2011
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life10/20/200811/16/2011
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities10/20/200811/16/2011
Pending ReplacementTransamerica Life Insurance Company300571Agent - Health10/1/2020 
Pending ReplacementTransamerica Life Insurance Company300571Agent - Life10/7/2009 
Pending ReplacementTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities10/7/2009 
InactiveTransamerica Premier Life Insurance Company300558Agent - Health10/1/201410/1/2020
InactiveTransamerica Premier Life Insurance Company300558Agent - Life10/1/201410/1/2020
InactiveTransamerica Premier Life Insurance Company300558Agent - Variable Life and Variable Annuities10/1/201410/1/2020
InactiveU.S. Financial Life Insurance Company301812Agent - Life12/26/20063/31/2007
InactiveVenerable Insurance and Annuity Company301006Agent - Life10/16/20175/18/2018
InactiveVenerable Insurance and Annuity Company301006Agent - Variable Life and Variable Annuities10/16/20175/18/2018
Pending ReplacementVoya Retirement Insurance and Annuity Company300643Agent - Life8/6/2007 
Pending ReplacementVoya Retirement Insurance and Annuity Company300643Agent - Variable Life and Variable Annuities8/6/2007 
Pending ReplacementWest Coast Life Insurance Company301607Agent - Health7/12/2011 
Pending ReplacementWest Coast Life Insurance Company301607Agent - Life7/12/2011 
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Health1/18/201310/1/2014
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Life1/18/201310/1/2014
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Variable Life and Variable Annuities1/18/201310/1/2014
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
Pending ReplacementWorld Financial Group Insurance Agency, LLC400520Agent - Health7/1/2011 
Pending ReplacementWorld Financial Group Insurance Agency, LLC400520Agent - Life7/1/2011 
Pending ReplacementWorld Financial Group Insurance Agency, LLC400520Agent - Variable Life and Variable Annuities7/1/2011 

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