DEPARTMENT OF INSURANCE

Affiliations

Name	Crockett, Elizabeth Wall	DOIID	802831	NAIC NPN	16205919

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Property	2/8/2013	8/31/2025
Active	Resident	Agent	Casualty	2/8/2013	8/31/2025
Active	Resident	Agent	Life	2/13/2013	8/31/2025
Active	Resident	Agent	Health	2/13/2013	8/31/2025
* 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
Active	ACE American Insurance Company	300625	Agent - Casualty	5/19/2015
Active	ACE American Insurance Company	300625	Agent - Property	5/19/2015
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Casualty	6/7/2016	12/9/2020
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Property	6/7/2016	12/9/2020
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Casualty	6/7/2016	12/9/2020
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Property	6/7/2016	12/9/2020
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	8/24/2016	12/20/2023
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Property	8/24/2016	12/20/2023
Active	AIG Property Casualty Company	300621	Agent - Casualty	3/8/2016
Active	AIG Property Casualty Company	300621	Agent - Property	3/8/2016
Inactive	All Savers Insurance Company	301940	Agent - Health	7/7/2015	10/31/2023
Inactive	All Savers Insurance Company	301940	Agent - Life	7/7/2015	10/31/2023
Inactive	American General Life Insurance Company	301585	Agent - Health	12/9/2016	12/23/2019
Inactive	American General Life Insurance Company	301585	Agent - Life	12/9/2016	12/23/2019
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/26/2013	6/7/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/26/2013	6/7/2017
Active	Bankers Standard Insurance Company	301620	Agent - Casualty	5/19/2015
Active	Bankers Standard Insurance Company	301620	Agent - Property	5/19/2015
Inactive	Banner Life Insurance Company	301696	Agent - Life	4/29/2013	10/22/2020
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	3/5/2013	10/12/2020
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	3/5/2013	10/12/2020
Active	Brighthouse Life Insurance Company	301829	Agent - Health	10/8/2014
Active	Brighthouse Life Insurance Company	301829	Agent - Life	10/8/2014
Active	Cincinnati Casualty Company (The)	300308	Agent - Casualty	2/26/2013
Active	Cincinnati Casualty Company (The)	300308	Agent - Property	2/26/2013
Active	Cincinnati Indemnity Company (The)	301566	Agent - Casualty	2/26/2013
Active	Cincinnati Indemnity Company (The)	301566	Agent - Property	2/26/2013
Active	Cincinnati Insurance Company	301298	Agent - Casualty	2/26/2013
Active	Cincinnati Insurance Company	301298	Agent - Property	2/26/2013
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Health	2/26/2013
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	2/26/2013
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	5/31/2013	12/13/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	1/13/2020	12/15/2020
Active	Forethought Life Insurance Company	301407	Agent - Health	7/15/2014
Active	Forethought Life Insurance Company	301407	Agent - Life	7/15/2014
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	7/22/2013	1/5/2015
Active	Guardian Life Insurance Company of America	301316	Agent - Health	3/5/2013
Active	Guardian Life Insurance Company of America	301316	Agent - Life	3/5/2013
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	5/31/2013	12/8/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	5/31/2013	12/13/2022
Inactive	Humana Insurance Company	301104	Agent - Health	5/31/2013	12/13/2022
Inactive	Humana Insurance Company	301104	Agent - Life	5/31/2013	12/13/2022
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/31/2013	6/15/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/13/2020	12/15/2020
Active	Indemnity Insurance Company of North America	301760	Agent - Casualty	5/19/2015
Active	Indemnity Insurance Company of North America	301760	Agent - Property	5/19/2015
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	1/27/2017	12/29/2020
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	1/27/2017	12/29/2020
Inactive	Kanawha Insurance Company	300127	Agent - Health	5/31/2013	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	5/31/2013	10/22/2015
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	11/11/2013	10/29/2015
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	3/25/2019	10/18/2022
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	3/25/2019	10/18/2022
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	10/8/2014	11/14/2014
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	10/8/2014	11/14/2014
Active	Metropolitan Life Insurance Company	301948	Agent - Health	10/14/2013
Active	Metropolitan Life Insurance Company	301948	Agent - Life	10/14/2013
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	2/12/2016	5/13/2022
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	2/12/2016	5/13/2022
Inactive	Old Guard Insurance Company	533854	Agent - Casualty	6/4/2021	6/15/2021
Inactive	Old Guard Insurance Company	533854	Agent - Property	6/4/2021	6/15/2021
Active	Pacific Employers Insurance Company	301753	Agent - Casualty	5/19/2015
Active	Pacific Employers Insurance Company	301753	Agent - Property	5/19/2015
Active	Principal National Life Insurance Company	301926	Agent - Life	11/5/2015
Active	Privilege Underwriters Reciprocal Exchange	769657	Agent - Casualty	12/13/2016
Active	Privilege Underwriters Reciprocal Exchange	769657	Agent - Property	12/13/2016
Inactive	Protective Life Insurance Company	300638	Agent - Health	5/14/2014	11/23/2019
Inactive	Protective Life Insurance Company	300638	Agent - Life	5/14/2014	11/23/2019
Inactive	Pruco Life Insurance Company	300954	Agent - Life	7/28/2014	12/22/2016
Inactive	Time Insurance Company	300683	Agent - Health	10/25/2013	12/20/2014
Inactive	Time Insurance Company	300683	Agent - Life	10/25/2013	12/20/2014
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/29/2017	3/27/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	3/29/2017	3/27/2023
Inactive	Westfield Champion Insurance Company	1054839	Agent - Casualty	6/4/2021	6/15/2021
Inactive	Westfield Champion Insurance Company	1054839	Agent - Property	6/4/2021	6/15/2021
Active	Westfield Insurance Company	301950	Agent - Casualty	10/4/2017
Active	Westfield Insurance Company	301950	Agent - Property	10/4/2017
Inactive	Westfield Premier Insurance Company	1055055	Agent - Casualty	6/4/2021	6/15/2021
Inactive	Westfield Premier Insurance Company	1055055	Agent - Property	6/4/2021	6/15/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Casualty	6/4/2021	6/15/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Property	6/4/2021	6/15/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Casualty	6/4/2021	6/15/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Property	6/4/2021	6/15/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Designated Agent Company Inc.	681257	Agent - Health	3/26/2013
Active	Designated Agent Company Inc.	681257	Agent - Life	3/26/2013
Active	Planchoice Inc.	400482	Agent - Health	4/17/2014
Inactive	Sterling G. Thompson Co.	399153	Agent - Casualty	2/26/2013	12/8/2016
Inactive	Sterling G. Thompson Co.	399153	Agent - Property	2/26/2013	12/8/2016
Inactive	Sterling G. Thompson Co.	399153	Agent - Health	2/26/2013	12/8/2016
Inactive	Sterling G. Thompson Co.	399153	Agent - Life	2/26/2013	12/8/2016
Active	Sterling Thompson Company	935239	Agent - Casualty	11/7/2016
Active	Sterling Thompson Company	935239	Agent - Property	11/7/2016
Active	Sterling Thompson Company	935239	Agent - Health	11/7/2016
Active	Sterling Thompson Company	935239	Agent - Life	11/7/2016