DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Dale Robert	DOIID	930895	NAIC NPN	17929839

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	9/26/2016	10/31/2025
Active	Non Resident	Agent	Life	9/26/2016	10/31/2025
* 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	08/15/2025	10/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	9/10/2021	11/11/2022
Inactive	Accendo Insurance Company	300312	Agent - Life	6/10/2020	11/11/2022
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	11/4/2016	11/11/2022
Inactive	American National Life Insurance Company of Texas	300912	Agent - Health	9/17/2018	8/15/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/24/2018	4/27/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/24/2018	4/27/2021
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	9/16/2021
Active	CHA HMO, Inc.	300662	Agent - Health	12/21/2023
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	9/10/2018
Active	CompBenefits Insurance Company	301864	Agent - Health	8/23/2021
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018	11/11/2022
Active	Dental Concern Inc. (The)	301641	Agent - Health	5/24/2023
Inactive	GPM Health and Life Insurance Company	927255	Agent - Health	8/20/2019	12/29/2021
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/10/2021
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	12/6/2022
Active	Humana Health Plan, Inc.	300142	Agent - Health	1/3/2024
Active	Humana Insurance Company	301104	Agent - Health	8/23/2021
Inactive	Humana Insurance Company	301104	Agent - Life	1/5/2018	6/8/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	1/5/2018	6/8/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/5/2018	6/8/2018
Active	Humana Medical Plan, Inc.	801568	Agent - Health	9/16/2021
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/7/2021
Inactive	Lumico Life Insurance Company	300354	Agent - Health	12/19/2018	11/1/2022
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	1/2/2018	12/29/2018
Inactive	United World Life Insurance Company	300532	Agent - Health	11/16/2018	12/29/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	12/13/2017	12/29/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	12/13/2017	12/29/2021
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/5/2021	9/15/2021
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	3/5/2021	9/15/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/5/2021	9/15/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	3/5/2021	9/15/2021
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	11/6/2020	12/14/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	11/6/2020	12/29/2021

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	9/25/2018	4/28/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	9/25/2018	4/28/2021
Inactive	Humana MarketPOINT Inc.	398092	Agent - Life	6/9/2022	11/11/2022
Active	Humana MarketPOINT Inc.	398092	Agent - Health	6/9/2022
Denied	TZ Insurance Solutions LLC	727470	Agent - Life
Inactive	TZ Insurance Solutions LLC	727470	Agent - Health	1/16/2017	2/24/2022