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.

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