DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	National Individual Insurance Agency, Llc	DOIID	1049053	NAIC NPN	18126287

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/29/2019		3/31/2027
Active	Non Resident	Agent	Life	7/29/2019		3/31/2027
* 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	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	1/26/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Brock, Harold L	393846	Agent - Health	7/29/2019
Active	Brock, Harold L	393846	Agent - Life	7/29/2019