DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Lively, Carla Ann	DOIID	777762	NAIC NPN	16586125

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	8/31/2017	10/1/2025
Inactive	Resident	Agent	Health	9/2/2021	10/1/2025
Inactive	Resident	Agent	Limited Line Credit	3/26/2012	9/30/2025
* 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
Inactive	American Health and Life Insurance Company	300844	Agent - Health	9/3/2021	1/27/2025
Inactive	American Health and Life Insurance Company	300844	Agent - Life	8/31/2017	1/27/2025
Inactive	American Health and Life Insurance Company	300844	Agent - Limited Line Credit	3/26/2012	1/27/2025
Inactive	Merit Life Insurance Co.	300150	Agent - Life	8/31/2017	12/14/2018
Inactive	Merit Life Insurance Co.	300150	Agent - Limited Line Credit	9/15/2016	12/14/2018
Inactive	Triton Insurance Company	300654	Agent - Limited Line Credit	3/26/2012	1/27/2025
Inactive	Yosemite Insurance Company	301519	Agent - Limited Line Credit	9/15/2016	1/23/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Interstate Agency Inc	610890	Agent - Limited Line Credit	8/10/2018	2/21/2019
Inactive	Interstate Agency Inc	610890	Agent - Life	8/10/2018	2/21/2019
Inactive	Onemain Assurance Services LLC	751094	Agent - Limited Line Credit	7/26/2018	1/27/2025
Inactive	Onemain Assurance Services LLC	751094	Agent - Life	6/19/2018	1/27/2025
Inactive	Onemain Assurance Services LLC	751094	Agent - Health	9/3/2021	1/27/2025