DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	McCarty, Samuel Elliott	DOIID	933521	NAIC NPN	18156095

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	10/26/2016	12/1/2019
Inactive	Resident	Agent	Life	10/26/2016	12/1/2019
* 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	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018	12/1/2019
Inactive	GPM Health and Life Insurance Company	927255	Agent - Health	7/13/2018	6/24/2019
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	4/3/2017	2/22/2018
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Health	11/3/2016	9/10/2019
Inactive	Woodmen of the World Life Insurance Society	301446	Agent - Life	11/3/2016	9/10/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Woodmen Insurance Agency, Inc.	579244	Agent - Life	1/3/2017	9/10/2019
Inactive	Woodmen Insurance Agency, Inc.	579244	Agent - Health	1/3/2017	12/1/2019