DEPARTMENT OF INSURANCE

Affiliations

Name	Ford, Brock	DOIID	694675	NAIC NPN	11062074

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	12/21/2021		7/31/2025
Active	Non Resident	Agent	Health	12/21/2021		7/31/2025
Inactive	Non Resident	Agent	Personal Lines	9/23/2009	7/31/2017
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	05/15/2025	07/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Home Insurance Company	301817	Agent - Personal Lines	5/30/2013	7/31/2017
Inactive	American Modern Home Insurance Company	300791	Agent - Personal Lines	5/30/2013	7/31/2017
Inactive	American Modern Select Insurance Company	581481	Agent - Personal Lines	5/30/2013	7/31/2017
Inactive	American Southern Home Insurance Company	626276	Agent - Personal Lines	5/30/2013	7/31/2017
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/11/2022	6/7/2022
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	1/11/2022	6/7/2022
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	1/11/2022	6/7/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/13/2022	6/7/2022
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/13/2022	6/7/2022
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	1/11/2022	6/7/2022
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Personal Lines	6/6/2011	7/12/2017
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Personal Lines	6/6/2011	7/12/2017
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Personal Lines	4/22/2010	7/31/2017
Inactive	LM General Insurance Company	300133	Agent - Personal Lines	4/22/2010	7/31/2017
Inactive	LM Insurance Corporation	301061	Agent - Personal Lines	4/22/2010	7/31/2017
Inactive	Liberty Insurance Corporation	300444	Agent - Personal Lines	4/22/2010	7/31/2017
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Personal Lines	4/22/2010	7/31/2017
Inactive	Liberty Mutual Insurance Company	301159	Agent - Personal Lines	4/22/2010	7/31/2017
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	11/11/2010	7/24/2017
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	11/11/2010	7/24/2017
Inactive	SAFECO Insurance Company of America	300159	Agent - Personal Lines	7/25/2014	7/31/2017
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Personal Lines	7/25/2014	7/31/2017
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Personal Lines	4/7/2014	7/31/2017
Inactive	The Phoenix Insurance Company	301502	Agent - Personal Lines	4/7/2014	12/21/2015
Inactive	Travelers Commercial Insurance Company	301506	Agent - Personal Lines	4/7/2014	7/31/2017
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Personal Lines	4/7/2014	7/31/2017
Inactive	Travelers Indemnity Company (The)	301855	Agent - Personal Lines	4/7/2014	12/21/2015
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Personal Lines	4/7/2014	7/31/2017
Inactive	Unitrin Direct Property & Casualty Company	637443	Agent - Personal Lines	10/22/2014	7/31/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Health	1/9/2014	7/24/2017
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Life	1/9/2014	7/24/2017
Inactive	Seabury & Smith Inc	394854	Agent - Health	4/8/2011	4/8/2014
Inactive	Seabury & Smith Inc	394854	Agent - Life	4/8/2011	4/8/2014
Inactive	Seabury & Smith Inc	394854	Agent - Personal Lines	2/3/2011	4/8/2014