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		11/30/2027
Active	Non Resident	Agent	Life	6/12/2024		11/30/2027
* 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	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