DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kelly, Benjamin Lane	DOIID	1123088	NAIC NPN	2480637

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	3/4/2021		1/31/2025
Active	Non Resident	Agent	Life	3/4/2021		1/31/2025
* 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	11/15/2024	01/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	All Savers Insurance Company	301940	Agent - Health	5/28/2024
Active	All Savers Insurance Company	301940	Agent - Life	5/28/2024
Active	American United Life Insurance Company	300498	Agent - Health	6/17/2024
Active	American United Life Insurance Company	300498	Agent - Life	6/17/2024
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/13/2021
Active	Anthem Life Insurance Company	301209	Agent - Health	10/13/2021
Active	Anthem Life Insurance Company	301209	Agent - Life	10/13/2021
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	2/1/2023
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	2/1/2023
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	11/4/2021	12/2/2021
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	11/4/2021	12/2/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	2/1/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Tis Ins Services Inc	523150	Agent - Life	11/15/2021
Active	Tis Ins Services Inc	523150	Agent - Health	11/15/2021