DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Patrick, Mark H	DOIID	942009	NAIC NPN	671753

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	1/13/2017		7/31/2026
Active	Non Resident	Agent	Life	1/13/2017		7/31/2026
Active	Non Resident	Agent	Property	1/13/2017		7/31/2026
Active	Non Resident	Agent	Health	1/13/2017		7/31/2026
* 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	05/15/2024	07/31/2024	05/15/2024	05/15/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	9/16/2019
Active	Anthem Life Insurance Company	301209	Agent - Health	9/19/2019
Active	Anthem Life Insurance Company	301209	Agent - Life	9/19/2019
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	2/27/2019
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	2/27/2019
Active	Tier One Insurance Company	301056	Agent - Health	8/30/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Alliant Insurance Services, Inc.	551378	Agent - Casualty
Denied	Alliant Insurance Services, Inc.	551378	Agent - Health
Denied	Alliant Insurance Services, Inc.	551378	Agent - Life
Denied	Alliant Insurance Services, Inc.	551378	Agent - Property