DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Fred D	DOIID	689735	NAIC NPN	7323271

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	3/30/2021	5/31/2026
Active	Non Resident	Agent	Property	3/30/2021	5/31/2026
Active	Non Resident	Agent	Health	3/30/2021	5/31/2026
Active	Non Resident	Agent	Casualty	3/30/2021	5/31/2026
* 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	03/15/2026	05/31/2026

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	4/3/2021
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	10/6/2021	12/19/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	10/6/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	4/3/2021	3/31/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/3/2021	3/31/2025
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	11/18/2014	8/2/2016
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Life	11/18/2014	8/2/2016
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	5/18/2020	5/31/2020
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	11/3/2014	12/8/2015
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	10/6/2021
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	11/3/2014	12/8/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Health	5/26/2020	5/31/2020
Inactive	Golden Rule Insurance Company	301943	Agent - Life	5/26/2020	5/31/2020
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/3/2014	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/3/2014	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/3/2014	12/8/2015
Inactive	Independence American Insurance Company	524747	Agent - Health	5/11/2017	5/31/2020
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/3/2014	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/3/2014	10/22/2015
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	8/14/2018	5/31/2020
Active	Standard Insurance Company	300185	Agent - Health	12/30/2024
Active	Standard Insurance Company	300185	Agent - Life	12/30/2024
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	12/11/2017	12/26/2018
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	12/11/2017	12/26/2018
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	4/8/2015	8/2/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	4/8/2015	8/2/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/25/2015	8/2/2016

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	10/17/2017	5/31/2020
Inactive	Designated Agent Company Inc.	681257	Agent - Life	10/17/2017	5/31/2020
Inactive	Gethealthinsurance Com Agency Inc	657389	Agent - Health	7/11/2016	8/2/2016
Inactive	Gethealthinsurance Com Agency Inc	657389	Agent - Life	7/11/2016	8/2/2016
Inactive	Medlink Inc	400721	Agent - Health	6/27/2016	8/2/2016
Inactive	Medlink Inc	400721	Agent - Life	6/27/2016	8/2/2016