DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Terbrack, William Edward	DOIID	896525	NAIC NPN	17468868

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	10/22/2015	4/30/2017
Inactive	Non Resident	Agent	Life	10/22/2015	4/30/2017
* 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	Chesapeake Life Insurance Company (The)	301017	Agent - Health	10/30/2015	3/3/2017
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	10/30/2015	3/3/2017
Inactive	HCC Life Insurance Company	301827	Agent - Health	7/20/2016	10/3/2016
Inactive	Unified Life Insurance Company	543169	Agent - Health	7/25/2016	6/19/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Eversurance, LLC	674377	Agent - Life	8/29/2016	3/3/2017
Inactive	Eversurance, LLC	674377	Agent - Health	8/29/2016	4/30/2017