DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Benjamin Edward	DOIID	707809	NAIC NPN	11300737

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	10/20/2014	12/31/2025
Active	Non Resident	Agent	Life	10/20/2014	12/31/2025
* 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	Accendo Insurance Company	300312	Agent - Health	9/10/2021	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	10/8/2019
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	7/18/2017
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/24/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	10/7/2019
Inactive	American Continental Insurance Company	643130	Agent - Life	7/18/2017	12/6/2021
Active	Anthem Life Insurance Company	301209	Agent - Health	9/22/2016
Active	Anthem Life Insurance Company	301209	Agent - Life	9/22/2016
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	8/24/2020
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Active	Chesapeake Life Insurance Company (The)	301017	Agent - Health	10/22/2014
Active	Chesapeake Life Insurance Company (The)	301017	Agent - Life	10/22/2014
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	12/3/2015	6/15/2018
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	7/18/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/3/2015	6/15/2018
Inactive	Golden Rule Insurance Company	301943	Agent - Health	11/12/2014	1/3/2024
Inactive	Golden Rule Insurance Company	301943	Agent - Life	11/12/2014	1/3/2024
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	12/3/2015	12/19/2019
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	12/3/2015	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/3/2015	6/15/2018
Active	Humana Insurance Company	301104	Agent - Health	4/13/2022
Inactive	Humana Insurance Company	301104	Agent - Life	12/3/2015	12/19/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/3/2015	6/15/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/3/2015	6/15/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	12/3/2015	6/15/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	6/15/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/23/2014	8/1/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/23/2014	8/1/2015
Inactive	S.USA Life Insurance Company, Inc.	301774	Agent - Life	7/25/2017	6/24/2019
Active	SilverScript Insurance Company	663526	Agent - Health	10/7/2019
Inactive	United American Insurance Company	300910	Agent - Health	12/7/2009	8/19/2010
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	3/13/2019
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/5/2019	12/22/2022
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/12/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/12/2015	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/13/2019	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	3/13/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Designated Agent Company Inc.	681257	Agent - Health	9/23/2016
Active	Designated Agent Company Inc.	681257	Agent - Life	9/23/2016
Active	HealthMarkets Insurance Agency Inc	709727	Agent - Health	10/23/2014
Active	HealthMarkets Insurance Agency Inc	709727	Agent - Life	10/22/2014