DEPARTMENT OF INSURANCE
Affiliations
NameBlack, Michael PDOIID756773NAIC NPN2888614
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth8/8/2013 5/31/2027
ActiveNon ResidentAgentProperty4/12/2018 5/31/2027
ActiveNon ResidentAgentVariable Life and Variable Annuities4/12/2018 5/31/2027
ActiveNon ResidentAgentCasualty4/12/2018 5/31/2027
ActiveNon ResidentAgentLife8/8/2013 5/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent03/15/202505/31/202504/10/202504/10/2025Yes
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAmerican Economy Insurance Company300315Agent - Casualty1/6/20234/16/2025
InactiveAmerican Economy Insurance Company300315Agent - Property1/6/20234/16/2025
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health11/27/2023 
ActiveAnthem Insurance Companies, Inc.300941Agent - Health11/27/2023 
InactiveAnthem Life Insurance Company301209Agent - Health11/27/20234/15/2025
InactiveAnthem Life Insurance Company301209Agent - Life11/27/20234/15/2025
InactiveBrickStreet Mutual Insurance Company709251Agent - Casualty11/27/202111/27/2021
InactiveEncova Life Insurance Company301818Agent - Life12/5/20221/1/2024
InactiveFamily Heritage Life Insurance Company of America301037Agent - Health1/17/20135/31/2013
InactiveFamily Heritage Life Insurance Company of America301037Agent - Life1/17/20135/31/2013
ActiveFidelity Security Life Insurance Company300466Agent - Health8/27/2024 
InactiveGrange Indemnity Insurance Company300793Agent - Casualty6/26/20234/7/2025
InactiveGrange Indemnity Insurance Company300793Agent - Property6/26/20234/7/2025
InactiveGrange Insurance Company300234Agent - Casualty6/26/20234/7/2025
InactiveGrange Insurance Company300234Agent - Property6/26/20234/7/2025
InactiveGrange Property & Casualty Insurance Company601680Agent - Casualty6/26/20234/7/2025
InactiveGrange Property & Casualty Insurance Company601680Agent - Property6/26/20234/7/2025
ActiveJackson National Life Insurance Company300486Agent - Life7/12/2018 
ActiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities7/12/2018 
InactiveMICO Insurance Company301664Agent - Casualty6/1/20218/18/2024
InactiveMICO Insurance Company301664Agent - Property6/1/20218/18/2024
InactiveMotorists Commercial Mutual Insurance Company301941Agent - Casualty6/1/20218/18/2024
InactiveMotorists Commercial Mutual Insurance Company301941Agent - Property6/1/20218/18/2024
InactiveNorthStone Insurance Company818905Agent - Casualty11/27/202111/27/2021
ActivePan-American Life Insurance Company301530Agent - Life1/1/2024 
InactivePinnaclePoint Insurance Company819085Agent - Casualty11/27/202111/27/2021
ActivePruco Life Insurance Company300954Agent - Life4/18/2018 
ActivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities4/18/2018 
InactiveSAFECO Insurance Company of Illinois301350Agent - Casualty2/17/20224/16/2025
InactiveSAFECO Insurance Company of Illinois301350Agent - Property2/17/20224/16/2025
InactiveSummitPoint Insurance Company819084Agent - Casualty11/27/202111/27/2021
InactiveTravelers Casualty Insurance Company of America300522Agent - Casualty11/10/20213/4/2025
InactiveTravelers Casualty Insurance Company of America300522Agent - Property11/10/20213/4/2025
InactiveTrustgard Insurance Company300104Agent - Casualty6/26/20234/7/2025
InactiveTrustgard Insurance Company300104Agent - Property6/26/20234/7/2025
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBlack & Associates Inc.1115523Agent - Property6/21/20233/31/2025
InactiveBlack & Associates Inc.1115523Agent - Casualty6/21/20233/31/2025
InactiveBlack & Associates Inc.1115523Agent - Health6/21/20233/31/2025
InactiveBlack & Associates Inc.1115523Agent - Life6/21/20233/31/2025
InactiveCity Insurance Agency, Inc.641335Agent - Property6/19/20223/31/2024
InactiveCity Insurance Agency, Inc.641335Agent - Casualty6/19/20223/31/2024
InactiveDesignated Agent Company Inc.681257Agent - Health11/19/20186/29/2021
InactiveDesignated Agent Company Inc.681257Agent - Life11/19/20186/30/2021
InactiveJarrell Black And Company, LLC1107857Agent - Property11/17/20223/31/2024
InactiveJarrell Black And Company, LLC1107857Agent - Casualty11/17/20223/31/2024
ActiveJarrell Black And Company, LLC1107857Agent - Health6/11/2024 
ActiveJarrell Black And Company, LLC1107857Agent - Life6/11/2024 
InactiveMedlink Inc400721Agent - Health11/17/20186/29/2021
InactiveMedlink Inc400721Agent - Life11/6/20183/31/2024

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