DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Wichtendahl, Kelly	DOIID	1102210	NAIC NPN	18150062

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/2/2020		9/30/2024
Active	Non Resident	Agent	Life	10/2/2020		9/30/2024
* 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	07/15/2024	09/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	1/20/2021
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	1/20/2021
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	1/20/2021
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Life	1/20/2021
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	1/20/2021
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Life	1/20/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Paychex Insurance Agency Inc	509469	Agent - Life	1/20/2021
Active	Paychex Insurance Agency Inc	509469	Agent - Health	1/20/2021