DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Burroughs, Thomas Randall	DOIID	308028	NAIC NPN	1893871

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	8/16/2024		3/31/2026
Active	Non Resident	Agent	Life	8/16/2024		3/31/2026
* 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	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/18/2007	3/31/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/18/2007	3/31/2016
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	2/22/2013	11/9/2015
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	2/22/2013	11/9/2015
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	2/22/2013	4/10/2016
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	2/22/2013	4/10/2016
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	9/27/1994	12/26/1997
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	9/27/1994	12/26/1997
Inactive	Paul Revere Protective Life Insurance Company (The)	301428	Agent - Health	9/27/1994	12/26/1997
Inactive	Paul Revere Protective Life Insurance Company (The)	301428	Agent - Life	9/27/1994	12/26/1997
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	12/5/1996	12/26/1997
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	12/5/1996	12/26/1997
Inactive	Pruco Life Insurance Company	300954	Agent - Life	10/11/2021	3/31/2024
Denied	Reassure America Life Insurance Company	301902	Agent - Health
Denied	Reassure America Life Insurance Company	301902	Agent - Life
Inactive	Unum Insurance Company	301499	Agent - Health	9/27/1994	12/26/1997
Inactive	Unum Insurance Company	301499	Agent - Life	9/27/1994	12/26/1997

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 - Life	12/16/2013	3/31/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/16/2013	3/31/2016
Inactive	Heritage Financial Group, LLC of Tennessee	524834	Agent - Life	1/18/2007	3/31/2013
Inactive	Heritage Financial Group, LLC of Tennessee	524834	Agent - Health	1/18/2007	3/31/2013