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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	03/15/2025	05/31/2025

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