DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Willis, Matthew Adam	DOIID	893713	NAIC NPN	17326821

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	9/30/2015		5/31/2025
Active	Non Resident	Agent	Property	9/30/2015		5/31/2025
Active	Non Resident	Agent	Health	9/30/2015		5/31/2025
Active	Non Resident	Agent	Life	9/30/2015		5/31/2025
* 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
Inactive	Humana Insurance Company	301104	Agent - Health	10/11/2022	5/2/2023
Inactive	State Farm Fire and Casualty Company	301809	Agent - Casualty	10/7/2015	4/25/2023
Inactive	State Farm Fire and Casualty Company	301809	Agent - Property	10/7/2015	4/25/2023
Inactive	State Farm Life Insurance Company	301810	Agent - Life	10/7/2015	4/25/2023
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Casualty	10/7/2015	4/25/2023
Inactive	State Farm Mutual Automobile Insurance Company	301732	Agent - Health	10/7/2015	4/25/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending	Humana MarketPOINT Inc.	398092	Agent - Life
Pending	Humana MarketPOINT Inc.	398092	Agent - Health