DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Delacey, Thomas G	DOIID	744762	NAIC NPN	6376278

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	6/12/2024		11/30/2025
Active	Non Resident	Agent	Life	6/12/2024		11/30/2025
* 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	09/15/2025	11/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/15/2011	11/30/2013
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/15/2011	11/30/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	1/15/2011	11/30/2013
Inactive	Designated Agent Company Inc.	681257	Agent - Health	1/15/2011	11/30/2013