DEPARTMENT OF INSURANCE

Affiliations

Name	Crisafulli, Kim C	DOIID	1049412	NAIC NPN	17651615

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Health	7/31/2019	5/31/2025
Pending Replacement	Non Resident	Agent	Life	1/6/2023	5/31/2025
* 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	03/15/2025	05/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	9/11/2020	9/18/2024
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	9/11/2020	9/18/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/11/2020	9/18/2024
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/28/2019	5/31/2025
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/23/2021	12/19/2024
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/23/2021	5/31/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/28/2019	12/16/2024
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/22/2019	12/13/2022
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/21/2022	6/19/2025
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/16/2021	5/31/2025
Pending Replacement	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	9/28/2024
Inactive	Great Western Insurance Company	501693	Agent - Life	2/9/2023	5/7/2024
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/16/2023	6/24/2025
Inactive	Humana Insurance Company	301104	Agent - Health	11/5/2021	12/12/2024
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	6/30/2020	6/24/2025
Inactive	S.USA Life Insurance Company, Inc.	301774	Agent - Life	1/27/2023	4/15/2024
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/10/2019	9/18/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	2/11/2020	6/19/2025
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	2/11/2020	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	2/11/2020	12/23/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	2/11/2020	6/19/2025
Pending Replacement	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	4/15/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	4/13/2021	12/29/2021

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	8/30/2019	2/10/2025