DEPARTMENT OF INSURANCE
Affiliations
NameClark, Elliott DOIID827485NAIC NPN17115303
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveResidentAgentVariable Life and Variable Annuities6/2/2014 5/31/2025
ActiveResidentAgentHealth12/12/2013 5/31/2025
ActiveResidentAgentLife11/21/2013 5/31/2025
* 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.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAmerican General Life Insurance Company301585Agent - Health12/2/2019 
ActiveAmerican General Life Insurance Company301585Agent - Life1/7/2019 
ActiveAmerican General Life Insurance Company301585Agent - Variable Life and Variable Annuities1/7/2019 
ActiveAmeritas Life Insurance Corporation300126Agent - Health2/1/2022 
InactiveAthene Annuity and Life Company301893Agent - Life9/24/20201/19/2022
InactiveBanner Life Insurance Company301696Agent - Life10/29/20195/28/2024
ActiveBrighthouse Life Insurance Company301829Agent - Health2/23/2018 
ActiveBrighthouse Life Insurance Company301829Agent - Life2/23/2018 
ActiveBrighthouse Life Insurance Company301829Agent - Variable Life and Variable Annuities2/23/2018 
ActiveCMFG Life Insurance Company300929Agent - Health2/8/2019 
ActiveCMFG Life Insurance Company300929Agent - Life2/8/2019 
ActiveCMFG Life Insurance Company300929Agent - Variable Life and Variable Annuities2/8/2019 
ActiveCincinnati Life Insurance Company (The)300601Agent - Life1/16/2020 
InactiveDelaware Life Insurance Company301256Agent - Life6/5/20194/12/2021
InactiveDelaware Life Insurance Company301256Agent - Variable Life and Variable Annuities6/5/20194/12/2021
InactiveEquitable Financial Life Insurance Company300808Agent - Variable Life and Variable Annuities2/28/20195/4/2021
ActiveForethought Life Insurance Company301407Agent - Health7/3/2018 
ActiveForethought Life Insurance Company301407Agent - Life7/3/2018 
ActiveForethought Life Insurance Company301407Agent - Variable Life and Variable Annuities7/3/2018 
InactiveFortitude Life Insurance & Annuity Company301503Agent - Life8/21/201812/24/2018
InactiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities8/21/201812/24/2018
ActiveIntegrity Life Insurance Company301687Agent - Life9/3/2021 
ActiveIntegrity Life Insurance Company301687Agent - Variable Life and Variable Annuities9/3/2021 
InactiveJackson National Life Insurance Company300486Agent - Life10/21/20151/9/2024
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities10/21/20151/9/2024
InactiveLincoln Life Assurance Company of Boston301915Agent - Life10/19/201510/10/2019
ActiveLincoln National Life Insurance Company (The)301382Agent - Health10/7/2015 
ActiveLincoln National Life Insurance Company (The)301382Agent - Life10/7/2015 
ActiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities10/7/2015 
ActiveMEMBERS Life Insurance Company301289Agent - Health2/8/2019 
ActiveMEMBERS Life Insurance Company301289Agent - Life2/8/2019 
ActiveMEMBERS Life Insurance Company301289Agent - Variable Life and Variable Annuities2/8/2019 
ActiveMassMutual Ascend Life Insurance Company300320Agent - Life9/14/2018 
ActiveMassMutual Ascend Life Insurance Company300320Agent - Variable Life and Variable Annuities4/7/2021 
ActiveMassachusetts Mutual Life Insurance Company300445Agent - Life5/15/2024 
InactiveMidland National Life Insurance Company300923Agent - Life6/26/20204/14/2021
InactiveMidland National Life Insurance Company300923Agent - Variable Life and Variable Annuities6/26/20204/14/2021
InactiveNationwide Life Insurance Company300495Agent - Health3/29/201812/17/2020
InactiveNationwide Life Insurance Company300495Agent - Life3/29/201812/17/2020
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities3/29/201812/17/2020
InactiveNationwide Life and Annuity Insurance Company300714Agent - Health5/10/201812/17/2020
InactiveNationwide Life and Annuity Insurance Company300714Agent - Life5/10/201812/17/2020
InactiveNationwide Life and Annuity Insurance Company300714Agent - Variable Life and Variable Annuities5/10/201812/17/2020
InactiveNew York Life Insurance and Annuity Corporation300726Agent - Life2/16/20184/8/2021
ActivePacific Life Insurance Company301848Agent - Health8/6/2021 
ActivePacific Life Insurance Company301848Agent - Life8/6/2021 
ActivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities8/6/2021 
ActivePenn Insurance and Annuity Company300712Agent - Life4/28/2022 
ActivePenn Mutual Life Insurance Company301394Agent - Life4/28/2022 
ActivePruco Life Insurance Company300954Agent - Life4/13/2018 
ActivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities4/13/2018 
ActiveS.USA Life Insurance Company, Inc.301774Agent - Life4/23/2021 
ActiveState Life Insurance Company301497Agent - Health10/6/2015 
InactiveState Life Insurance Company301497Agent - Life10/6/201511/16/2023
ActiveSymetra Life Insurance Company301691Agent - Health2/20/2018 
ActiveSymetra Life Insurance Company301691Agent - Life2/20/2018 
ActiveSymetra Life Insurance Company301691Agent - Variable Life and Variable Annuities2/20/2018 
ActiveTransamerica Life Insurance Company300571Agent - Life10/19/2015 
ActiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities10/19/2015 
ActiveWestern-Southern Life Assurance Company301590Agent - Health9/3/2021 
ActiveWestern-Southern Life Assurance Company301590Agent - Life9/3/2021 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveFifth Third Insurance Agency Inc399341Agent - Life6/19/20147/7/2015
InactiveFifth Third Insurance Agency Inc399341Agent - Health6/10/20147/7/2015
InactiveFifth Third Insurance Agency Inc399341Agent - Variable Life and Variable Annuities6/10/20147/7/2015
InactiveHuntington Investment Co The633475Agent - Life4/15/20204/16/2021
InactiveHuntington Investment Co The633475Agent - Variable Life and Variable Annuities4/15/20204/16/2021
ActiveLPL FINANCIAL LLC399327Agent - Life4/14/2021 
ActiveLPL FINANCIAL LLC399327Agent - Health4/14/2021 
ActiveLPL FINANCIAL LLC399327Agent - Variable Life and Variable Annuities4/14/2021 

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