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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	02/15/2027	04/30/2027

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