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DEPARTMENT OF INSURANCE
Affiliations
Name
Blackwell, Tim S
DOIID
758055
NAIC NPN
16288499
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Pending Replacement
Non Resident
Agent
Life
1/10/2018
6/30/2024
Pending Replacement
Non Resident
Agent
Health
1/10/2018
6/30/2024
* 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
04/15/2024
06/30/2024
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Aetna Health Inc. (PA)
660717
Agent - Health
1/24/2012
6/30/2014
Inactive
Aetna Life Insurance Company
301140
Agent - Health
1/24/2012
6/30/2014
Inactive
Aetna Life Insurance Company
301140
Agent - Life
1/24/2012
6/30/2014
Inactive
American Continental Insurance Company
643130
Agent - Health
7/21/2011
6/30/2014
Inactive
American Continental Insurance Company
643130
Agent - Life
7/21/2011
6/30/2014
Pending Replacement
American General Life Insurance Company
301585
Agent - Life
10/3/2022
Inactive
American Retirement Life Insurance Company
706303
Agent - Health
11/19/2013
6/30/2014
Inactive
American Retirement Life Insurance Company
706303
Agent - Life
11/19/2013
6/30/2014
Inactive
Americo Financial Life and Annuity Insurance Company
300869
Agent - Health
3/28/2018
6/7/2023
Inactive
Americo Financial Life and Annuity Insurance Company
300869
Agent - Life
3/28/2018
6/7/2023
Inactive
CompBenefits Dental, Inc.
591692
Agent - Health
2/21/2012
5/20/2014
Inactive
Continental Life Insurance Company of Brentwood Tennessee
301526
Agent - Health
7/21/2011
6/30/2014
Inactive
Continental Life Insurance Company of Brentwood Tennessee
301526
Agent - Life
7/21/2011
6/30/2014
Inactive
Dental Concern Inc. (The)
301641
Agent - Health
2/21/2012
5/20/2014
Inactive
First Health Life & Health Insurance Company
301735
Agent - Health
4/16/2012
6/30/2014
Pending Replacement
Gerber Life Insurance Company
300529
Agent - Health
9/23/2022
Pending Replacement
Gerber Life Insurance Company
300529
Agent - Life
9/23/2022
Inactive
Government Personnel Mutual Life Insurance Company
301862
Agent - Health
7/20/2011
6/30/2014
Inactive
Government Personnel Mutual Life Insurance Company
301862
Agent - Life
7/20/2011
6/30/2014
Inactive
Great Southern Life Insurance Company
301443
Agent - Health
8/13/2019
4/6/2023
Inactive
Humana Health Plan of Ohio Inc.
301565
Agent - Health
10/10/2012
6/30/2014
Inactive
Humana Health Plan, Inc.
300142
Agent - Health
2/21/2012
6/30/2014
Inactive
Humana Insurance Company
301104
Agent - Health
2/3/2012
6/30/2014
Inactive
Humana Insurance Company
301104
Agent - Life
2/3/2012
6/30/2014
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Health
2/21/2012
6/30/2014
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Life
2/21/2012
6/30/2014
Pending Replacement
Lumico Life Insurance Company
300354
Agent - Life
1/17/2023
Inactive
Mutual of Omaha Insurance Company
301012
Agent - Health
5/3/2012
4/22/2013
Inactive
Omaha Insurance Company
751908
Agent - Health
5/23/2012
6/30/2014
Inactive
United of Omaha Life Insurance Company
300156
Agent - Health
5/3/2012
6/24/2013
Inactive
United of Omaha Life Insurance Company
300156
Agent - Life
5/3/2012
6/24/2013
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Health
9/30/2011
6/24/2013
Inactive
UnitedHealthcare of Ohio, Inc.
300493
Agent - Health
9/30/2011
6/24/2013
Inactive
WellCare Prescription Insurance Inc.
654329
Agent - Health
12/10/2018
5/13/2021
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Broadway Benefits Group LLC
1222862
Agent - Life
8/12/2022
3/31/2024
Inactive
Broadway Benefits Group LLC
1222862
Agent - Health
8/12/2022
3/31/2024
Inactive
Designated Agent Company Inc.
681257
Agent - Life
12/16/2013
6/30/2014
Inactive
Designated Agent Company Inc.
681257
Agent - Health
12/16/2013
6/30/2014
Inactive
Ritter Ins Marketing LLC
718865
Agent - Life
3/29/2012
6/30/2014
Inactive
Ritter Ins Marketing LLC
718865
Agent - Health
3/29/2012
6/30/2014
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