DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Michael	DOIID	963205	NAIC NPN	17433360

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	8/9/2017		3/31/2027
Active	Non Resident	Agent	Health	8/9/2017		3/31/2027
* 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	01/15/2025	03/31/2025	01/29/2025	01/29/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	All Savers Insurance Company	301940	Agent - Health	12/26/2023
Active	All Savers Insurance Company	301940	Agent - Life	12/26/2023
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	8/14/2017
Active	CIGNA Health & Life Insurance Company	301783	Agent - Life	8/14/2017
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	12/26/2023
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	12/26/2023
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	12/26/2023
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	12/26/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Gallagher Benefit Services Inc	525782	Agent - Health	4/5/2024
Active	Gallagher Benefit Services Inc	525782	Agent - Life	4/5/2024