DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Edward O	DOIID	922005	NAIC NPN	610603

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/24/2021	7/31/2024
Inactive	Non Resident	Agent	Life	8/24/2021	7/31/2024
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	9/9/2021	4/27/2024
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	9/9/2021	4/27/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/9/2021	4/27/2024
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	9/9/2021	12/9/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/12/2016	12/16/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/12/2016	12/16/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	7/25/2016	4/10/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	7/25/2016	4/10/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	7/25/2016	4/10/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	7/25/2016	4/10/2017
Inactive	Humana Insurance Company	301104	Agent - Health	7/25/2016	4/10/2017
Inactive	Humana Insurance Company	301104	Agent - Life	7/25/2016	4/10/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	7/25/2016	4/10/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	7/25/2016	4/10/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	7/25/2016	4/10/2017
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	4/10/2017
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/9/2021	4/27/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	8/12/2016	4/10/2017
Inactive	Designated Agent Company Inc.	681257	Agent - Health	8/12/2016	4/10/2017