DEPARTMENT OF INSURANCE

Affiliations

Name	Crockett, Henry	DOIID	963701	NAIC NPN	18506270

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Health	9/1/2017	3/31/2025
Active	Resident	Agent	Property	12/8/2017	3/31/2025
Active	Resident	Agent	Life	8/29/2017	3/31/2025
Active	Resident	Agent	Casualty	12/7/2017	3/31/2025
* 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	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American United Life Insurance Company	300498	Agent - Health	11/16/2023
Active	American United Life Insurance Company	300498	Agent - Life	11/16/2023
Active	Anthem Life Insurance Company	301209	Agent - Health	10/6/2017
Active	Anthem Life Insurance Company	301209	Agent - Life	10/6/2017
Inactive	CompBenefits Insurance Company	301864	Agent - Health	3/23/2020	12/15/2020
Active	Dental Concern Inc. (The)	301641	Agent - Health	8/2/2022
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	5/10/2023
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	5/10/2023
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	12/30/2020
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	12/30/2020
Active	Humana Health Plan, Inc.	300142	Agent - Health	12/30/2020
Active	Humana Insurance Company	301104	Agent - Health	12/19/2018
Active	Humana Insurance Company	301104	Agent - Life	12/19/2018
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	12/30/2020
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	12/30/2020
Active	Humana Medical Plan, Inc.	801568	Agent - Health	12/30/2020
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/30/2020
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	11/8/2021
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	11/8/2021
Active	ManhattanLife Insurance and Annuity Company	301795	Agent - Health	4/26/2023
Active	ManhattanLife Insurance and Annuity Company	301795	Agent - Life	4/26/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Designated Agent Company Inc.	681257	Agent - Health	10/10/2017
Active	Designated Agent Company Inc.	681257	Agent - Life	10/10/2017
Active	Mcgriff Insurance Services, LLC	400877	Agent - Health	10/6/2017
Active	Mcgriff Insurance Services, LLC	400877	Agent - Life	10/6/2017