DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Grimm, Jack Call	DOIID	329648	NAIC NPN	1723325

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	4/27/1995		11/30/2025
Active	Non Resident	Agent	Health	4/27/1995		11/30/2025
* 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	09/15/2025	11/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anthem Life Insurance Company	301209	Agent - Health	4/19/2011	11/2/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/19/2011	11/2/2016
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	6/3/2011	10/12/2020
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	6/3/2011	10/12/2020
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	4/27/1995	6/11/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	4/27/1995	6/11/2014
Inactive	First Colony Life Insurance Company	301179	Agent - Life	7/19/2005	1/1/2007
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	12/4/2007
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	6/3/2011	10/5/2021
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	6/3/2011	10/5/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	City National Bank of West Virginia, Inc	512598	Agent - Life	11/5/2010	11/5/2010
Inactive	City National Bank of West Virginia, Inc	512598	Agent - Health	11/5/2010	11/5/2010
Inactive	Designated Agent Company Inc.	681257	Agent - Life	4/19/2011	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	4/19/2011	11/2/2016