DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Blackburn, Zachary Dean	DOIID	969057	NAIC NPN	18520632

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/22/2017		4/30/2027
* 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
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	9/27/2017
Inactive	Independence American Insurance Company	524747	Agent - Health	1/3/2019	12/30/2022
Active	LifeSecure Insurance Company	301629	Agent - Health	6/9/2021
Active	Madison National Life Insurance Company Inc.	301458	Agent - Health	7/21/2020
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	12/5/2017	12/26/2018

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 - Health	9/28/2017	2/3/2025