DEPARTMENT OF INSURANCE

Affiliations

Name	Brokers Alliance	DOIID	709745	NAIC NPN	2102629

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	1/20/2026	3/31/2027
Active	Non Resident	Agent	Life	7/21/2009	3/31/2027
* 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	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Accendo Insurance Company	300312	Agent - Life	6/2/2025
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	1/23/2026
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	1/24/2026
Active	Aetna Life Insurance Company	301140	Agent - Health	1/24/2026
Inactive	American Continental Insurance Company	643130	Agent - Life	8/15/2017	8/11/2021
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	6/16/2011	8/27/2012
Active	American General Life Insurance Company	301585	Agent - Life	11/4/2016
Active	American National Insurance Company	301861	Agent - Life	12/18/2014
Inactive	American United Life Insurance Company	300498	Agent - Life	4/17/2012	12/29/2016
Active	American-Amicable Life Insurance Co. of Texas	300257	Agent - Life	4/2/2025
Inactive	Assurity Life Insurance Company	301099	Agent - Life	11/3/2009	12/23/2016
Active	Banner Life Insurance Company	301696	Agent - Life	9/30/2011
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	1/23/2026
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	6/2/2025
Active	EquiTrust Life Insurance Company	502870	Agent - Life	4/30/2024
Active	Equitable Financial Life Insurance Company	300808	Agent - Life	2/20/2010
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	9/20/2021
Inactive	Forethought Life Insurance Company	301407	Agent - Life	8/16/2011	12/15/2025
Inactive	Genworth Life Insurance Company	300623	Agent - Life	10/2/2009	12/3/2019
Active	Gerber Life Insurance Company	300529	Agent - Health	6/1/2026
Active	Gerber Life Insurance Company	300529	Agent - Life	2/3/2014
Active	Guarantee Trust Life Insurance Company	301043	Agent - Health	5/18/2026
Active	Guarantee Trust Life Insurance Company	301043	Agent - Life	5/18/2026
Inactive	Guaranty Income Life Insurance Company	552451	Agent - Life	4/16/2022	8/26/2024
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/29/2017	4/20/2018
Active	Life Insurance Company of the Southwest	301867	Agent - Life	12/8/2020
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	11/23/2009
Inactive	Lumico Life Insurance Company	300354	Agent - Life	9/17/2021	10/9/2024
Active	Nassau Life and Annuity Company	513671	Agent - Life	2/22/2019
Inactive	National Western Life Insurance Company	301515	Agent - Life	11/26/2012	3/29/2023
Active	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	11/12/2009
Active	North American Company for Life and Health Insurance	300291	Agent - Life	7/16/2011
Inactive	PHL Variable Insurance Company	300525	Agent - Life	1/28/2014	12/2/2020
Active	Pacific Life Insurance Company	301848	Agent - Life	3/20/2017
Inactive	Pioneer Mutual Life Insurance Company	501695	Agent - Life	4/17/2012	12/29/2016
Active	Protective Life Insurance Company	300638	Agent - Life	3/31/2021
Active	Pruco Life Insurance Company	300954	Agent - Life	4/8/2014
Inactive	Reserve National Insurance Company	301073	Agent - Life	6/9/2014	5/24/2021
Active	Royal Neighbors of America	301646	Agent - Life	2/2/2021
Active	SilverScript Insurance Company	663526	Agent - Health	1/24/2026
Active	State Life Insurance Company	301497	Agent - Life	4/17/2012
Active	The American Home Life Insurance Company	563717	Agent - Life	4/14/2026
Active	Tier One Insurance Company	301056	Agent - Life	8/21/2024
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	1/23/2026	4/7/2026
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	1/23/2026	4/7/2026

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Racich, David Joseph	719845	Agent - Life	5/4/2012
Inactive	Racich, Joseph Michael	555191	Agent - Life	7/21/2009	5/4/2012
Active	Truhlar, Charles A	1029193	Agent - Health	1/20/2026