DEPARTMENT OF INSURANCE

Affiliations

Name	Legacy Planning And Solutions LLC	DOIID	809055	NAIC NPN	16953040

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Health	5/3/2013	3/31/2025
Active	Resident	Agent	Life	5/3/2013	3/31/2025
Denied	Resident	Agent	Casualty
Denied	Resident	Agent	Property
* 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	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Accendo Insurance Company	300312	Agent - Health	3/9/2021
Active	Accendo Insurance Company	300312	Agent - Life	3/9/2021
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	3/1/2021
Active	Aetna Health and Life Insurance Company	300523	Agent - Life	3/1/2021
Active	American Benefit Life Insurance Company	301002	Agent - Life	7/17/2017
Inactive	American Continental Insurance Company	643130	Agent - Health	3/9/2021	8/10/2021
Inactive	American Continental Insurance Company	643130	Agent - Life	3/9/2021	8/11/2021
Active	American National Insurance Company	301861	Agent - Life	5/19/2022
Active	American-Amicable Life Insurance Co. of Texas	300257	Agent - Life	6/24/2023
Active	Assurity Life Insurance Company	301099	Agent - Health	6/16/2021
Active	Assurity Life Insurance Company	301099	Agent - Life	6/16/2021
Active	Banner Life Insurance Company	301696	Agent - Life	6/26/2021
Active	Columbian Life Insurance Company	300810	Agent - Life	1/15/2019
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/9/2021
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	3/9/2021
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/11/2017	7/11/2019
Active	EquiTrust Life Insurance Company	502870	Agent - Life	2/14/2020
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	5/2/2019
Active	Forethought Life Insurance Company	301407	Agent - Health	10/31/2018
Active	Forethought Life Insurance Company	301407	Agent - Life	10/31/2018
Active	Gerber Life Insurance Company	300529	Agent - Health	11/1/2021
Active	Gerber Life Insurance Company	300529	Agent - Life	11/1/2021
Inactive	Homesteaders Life Company	300836	Agent - Life	12/27/2017	7/13/2020
Inactive	Humana Insurance Company	301104	Agent - Health	8/11/2017	7/11/2019
Inactive	Humana Insurance Company	301104	Agent - Life	8/11/2017	7/11/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/11/2017	6/15/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/11/2017	6/15/2018
Inactive	Independent Order of Foresters	300743	Agent - Life	12/29/2020	12/29/2021
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/11/2017	12/8/2017
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/11/2017	12/8/2017
Active	Kentucky Funeral Directors Life Insurance Company	532905	Agent - Life	3/4/2023
Active	Liberty Bankers Life Insurance Company	542461	Agent - Life	12/1/2022
Active	Life Insurance Company of the Southwest	301867	Agent - Health	10/9/2018
Active	Life Insurance Company of the Southwest	301867	Agent - Life	10/9/2018
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	12/10/2018
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	12/10/2018
Active	National Guardian Life Insurance Company	300596	Agent - Life	12/30/2016
Active	National Life Insurance Company	301852	Agent - Health	11/2/2018
Active	National Life Insurance Company	301852	Agent - Life	11/2/2018
Active	National Western Life Insurance Company	301515	Agent - Life	6/13/2019
Active	North American Company for Life and Health Insurance	300291	Agent - Life	4/12/2020
Active	Pioneer American Insurance Company	301268	Agent - Life	12/5/2023
Active	Southern Financial Life Insurance Company	300664	Agent - Life	10/1/2017
Active	Tier One Insurance Company	301056	Agent - Health	10/24/2022
Active	Tier One Insurance Company	301056	Agent - Life	8/17/2022
Active	Transamerica Life Insurance Company	300571	Agent - Health	12/5/2017
Active	Transamerica Life Insurance Company	300571	Agent - Life	12/5/2017
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	7/11/2019	10/1/2020
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	7/11/2019	10/1/2020
Inactive	Unified Life Insurance Company	543169	Agent - Health	6/23/2017	12/28/2018
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/5/2017	4/2/2019
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	10/5/2017	12/20/2018
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/5/2017	3/29/2019

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Clemens, Carolyn Noreen	364335	Agent - Health	5/3/2013
Active	Clemens, Carolyn Noreen	364335	Agent - Life	5/3/2013
Denied	Clemens, Randall Fredrick	665366	Agent - Casualty
Inactive	Clemens, Randall Fredrick	665366	Agent - Health	5/3/2013	10/1/2022
Inactive	Clemens, Randall Fredrick	665366	Agent - Life	5/3/2013	10/1/2022
Denied	Clemens, Randall Fredrick	665366	Agent - Property
Inactive	Dickerson, Sandra Kathalean	356831	Agent - Health	5/3/2013	6/1/2014
Inactive	Dickerson, Sandra Kathalean	356831	Agent - Life	5/3/2013	6/1/2014
Denied	Simmons, Jason Joseph	715883	Agent - Health
Denied	Simmons, Jason Joseph	715883	Agent - Life