DEPARTMENT OF INSURANCE

Affiliations

Name	Embry, David Wayne	DOIID	772749	NAIC NPN	16490016

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	7/23/2014	9/30/2025
Active	Non Resident	Agent	Property	12/9/2016	9/30/2025
Active	Non Resident	Agent	Casualty	12/9/2016	9/30/2025
Active	Non Resident	Agent	Health	7/23/2014	9/30/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	6/8/2020	9/30/2025
* 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	07/15/2025	09/30/2025
Surplus Lines Broker	07/15/2025	09/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	7/31/2024
Active	ACUITY, A Mutual Insurance Company	300095	Agent - Property	7/31/2024
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Casualty	1/15/2020
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Property	1/15/2020
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Casualty	1/15/2020
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Property	1/15/2020
Active	AmGUARD Insurance Company	500010	Agent - Casualty	3/14/2023
Active	AmGUARD Insurance Company	500010	Agent - Property	3/14/2023
Active	American Casualty Company of Reading, Pennsylvania	300956	Agent - Casualty	7/15/2024
Active	American Casualty Company of Reading, Pennsylvania	300956	Agent - Property	7/15/2024
Active	American Economy Insurance Company	300315	Agent - Casualty	11/1/2024
Active	American Economy Insurance Company	300315	Agent - Property	11/1/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Health	5/22/2020	12/16/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/22/2020	12/16/2024
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/31/2014	3/14/2019
Inactive	Continental General Insurance Company	300691	Agent - Health	8/9/2018	1/25/2019
Inactive	Continental General Insurance Company	300691	Agent - Life	8/9/2018	1/25/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/31/2014	12/19/2019
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	1/13/2021	5/27/2024
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	1/13/2021	5/27/2024
Inactive	Government Personnel Mutual Life Insurance Company	301862	Agent - Health	2/3/2012	12/26/2012
Inactive	Government Personnel Mutual Life Insurance Company	301862	Agent - Life	2/3/2012	12/26/2012
Active	Guardian Life Insurance Company of America	301316	Agent - Health	6/4/2020
Active	Guardian Life Insurance Company of America	301316	Agent - Life	6/4/2020
Active	Hanover American Insurance Company (The)	300447	Agent - Casualty	1/15/2020
Active	Hanover American Insurance Company (The)	300447	Agent - Property	1/15/2020
Active	Hanover Insurance Company (The)	300508	Agent - Casualty	1/15/2020
Active	Hanover Insurance Company (The)	300508	Agent - Property	1/15/2020
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	3/7/2022
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	3/7/2022
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/3/2020	12/13/2022
Inactive	Humana Insurance Company	301104	Agent - Health	6/17/2021	12/13/2022
Inactive	Humana Insurance Company	301104	Agent - Life	10/31/2014	12/19/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	6/17/2021	12/13/2022
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/31/2014	8/9/2018
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/31/2014	8/9/2018
Active	Massachusetts Bay Insurance Company	300898	Agent - Casualty	1/15/2020
Active	Massachusetts Bay Insurance Company	300898	Agent - Property	1/15/2020
Active	Metropolitan Life Insurance Company	301948	Agent - Health	3/10/2016
Active	Metropolitan Life Insurance Company	301948	Agent - Life	3/10/2016
Active	Mount Vernon Fire Insurance Company	301397	Agent - Casualty	7/26/2022
Active	Mount Vernon Fire Insurance Company	301397	Agent - Property	7/26/2022
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	2/2/2012	12/26/2012
Active	National Guardian Life Insurance Company	300596	Agent - Health	9/15/2021
Active	National Specialty Insurance Company	300993	Agent - Casualty	9/6/2024
Active	National Specialty Insurance Company	300993	Agent - Property	9/6/2024
Active	Nationwide Life Insurance Company	300495	Agent - Health	9/29/2021
Active	Nationwide Life Insurance Company	300495	Agent - Life	9/29/2021
Active	Next Insurance US Company	1083825	Agent - Casualty	8/6/2024
Active	Next Insurance US Company	1083825	Agent - Property	8/6/2024
Active	NorGUARD Insurance Company	500015	Agent - Casualty	3/14/2023
Active	Ohio Security Insurance Company	300622	Agent - Casualty	7/13/2023
Active	Ohio Security Insurance Company	300622	Agent - Property	7/13/2023
Inactive	Omaha Insurance Company	751908	Agent - Health	5/24/2012	5/22/2013
Active	Plaza Insurance Company	300748	Agent - Casualty	5/7/2023
Active	Plaza Insurance Company	300748	Agent - Property	5/7/2023
Active	State National Insurance Company, Inc.	300888	Agent - Casualty	9/6/2024
Active	State National Insurance Company, Inc.	300888	Agent - Property	9/6/2024
Inactive	The Savings Bank Mutual Life Insurance Company of Massachusetts	690290	Agent - Life	5/15/2019	12/16/2022
Active	United States Fire Insurance Company	582240	Agent - Casualty	6/30/2023
Active	United States Fire Insurance Company	582240	Agent - Property	6/30/2023
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	2/2/2012	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	2/2/2012	12/26/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	8/25/2022	11/30/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	8/25/2022	11/30/2023
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/25/2022	11/30/2023
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	8/25/2022	11/30/2023
Active	Valley Forge Insurance Company	301052	Agent - Casualty	7/16/2023
Active	Valley Forge Insurance Company	301052	Agent - Property	7/16/2023
Active	Verlan Fire Insurance Company	517102	Agent - Casualty	1/15/2020
Active	Verlan Fire Insurance Company	517102	Agent - Property	1/15/2020
Active	Wellfleet Insurance Company	300542	Agent - Casualty	8/7/2020
Active	Wellfleet New York Insurance Company	300245	Agent - Casualty	8/7/2020
Active	Wellfleet New York Insurance Company	300245	Agent - Property	8/7/2020

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	5/26/2020	2/10/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Health	5/26/2020	2/10/2025
Inactive	LOCKTON AFFINITY, LLC	524069	Agent - Life	10/17/2016	5/15/2019
Inactive	LOCKTON AFFINITY, LLC	524069	Agent - Health	10/17/2016	5/15/2019
Active	Mylo LLC	973654	Agent - Life	4/6/2018
Active	Mylo LLC	973654	Agent - Health	4/6/2018
Active	Mylo LLC	973654	Agent - Property	6/10/2020
Active	Mylo LLC	973654	Agent - Casualty	6/10/2020
Active	Mylo LLC	973654	Surplus Lines Broker - Not Applicable	6/10/2020