DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Wagner, Darcy	DOIID	856116	NAIC NPN	16944302

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	3/16/2026		3/31/2027
Active	Non Resident	Agent	Life	10/11/2014		3/31/2027
Active	Non Resident	Agent	Health	10/11/2014		3/31/2027
* 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
Administrator	01/15/2027	03/31/2027
Agent	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/24/2014	3/14/2016
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/24/2014	3/14/2016
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	10/24/2014	3/14/2016
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	10/24/2014	3/14/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Self Insured Services Company, LLC	397375	Administrator - Not Applicable	3/19/2026