DEPARTMENT OF INSURANCE

Affiliations

Name	Kaelin, Michael Lee	DOIID	319319	NAIC NPN	547403

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Administrator	Not Applicable	10/19/2011		4/30/2025
Active	Resident	Agent	Casualty	8/15/2000		4/30/2025
Active	Resident	Agent	Life	5/11/1973		4/30/2025
Active	Resident	Agent	Health	5/11/1973		4/30/2025
Active	Resident	Agent	Property	8/15/2000		4/30/2025
Active	Resident	Agent	Variable Life and Variable Annuities	5/31/2001		4/30/2025
Inactive	Resident	Agent	Prepaid Dental Plan	3/19/1996	3/1/2001
Inactive	Resident	Agent	General Lines	9/29/1980	8/15/2000
Inactive	Resident	Agent	Health Maintenance Organization	9/18/1997	3/1/2001
Denied	Resident	Life & Health Consultant	Not Applicable
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	4 Ever Life Insurance Company	301307	Agent - Health	7/20/2005	4/3/2008
Inactive	4 Ever Life Insurance Company	301307	Agent - Life	7/20/2005	4/3/2008
Inactive	ADENTA, Inc.	301437	Agent - Prepaid Dental Plan	9/18/1996	3/31/1997
Active	Accendo Insurance Company	300312	Agent - Life	1/21/2021
Inactive	Aetna Health Inc.	300694	Agent - Health	3/1/2001	12/31/2007
Inactive	Aetna Health Inc.	300694	Agent - Health Maintenance Organization	10/9/2000	3/1/2001
Active	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	1/21/2021
Active	Aetna Life Insurance Company	301140	Agent - Health	10/9/2000
Active	Aetna Life Insurance Company	301140	Agent - Life	7/21/2005
Active	All Savers Insurance Company	301940	Agent - Health	1/11/2022
Active	All Savers Insurance Company	301940	Agent - Life	1/11/2022
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	11/13/2013	1/9/2017
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	11/13/2013	1/9/2017
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	11/13/2013	1/9/2017
Inactive	American Bankers Life Assurance Company of Florida	300171	Agent - Health	8/20/1990	9/3/1998
Inactive	American Bankers Life Assurance Company of Florida	300171	Agent - Life	8/20/1990	9/3/1998
Inactive	American Continental Insurance Company	643130	Agent - Life	1/21/2021	8/11/2021
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	1/6/2011
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	1/6/2011
Inactive	American Fidelity Assurance Company	301004	Agent - Health	4/1/2014	8/11/2016
Inactive	American Fidelity Assurance Company	301004	Agent - Life	4/1/2014	8/11/2016
Inactive	American General Life Insurance Company	301585	Agent - Health	6/24/2015	1/26/2018
Inactive	American General Life Insurance Company	301585	Agent - Life	6/24/2015	1/26/2018
Inactive	American General Life Insurance Company	301585	Agent - Variable Life and Variable Annuities	6/24/2015	1/15/2022
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	10/4/1999	12/27/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	10/4/1999	12/27/2012
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	12/19/2018	2/28/2019
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	12/19/2018	2/28/2019
Inactive	American States Life Insurance Company	301884	Agent - Health	11/1/1998	12/6/2004
Inactive	American States Life Insurance Company	301884	Agent - Life	11/1/1998	12/6/2004
Active	American United Life Insurance Company	300498	Agent - Health	2/13/2024
Active	American United Life Insurance Company	300498	Agent - Life	2/13/2024
Inactive	American United Life Insurance Company	300498	Agent - Variable Life and Variable Annuities	7/1/2021	7/31/2023
Active	Ameritas Life Insurance Corporation	300126	Agent - Health	12/31/2016
Active	Ameritas Life Insurance Corporation	300126	Agent - Life	12/31/2016
Inactive	Ameritas Variable Life Insurance Company	300665	Agent - Health	4/13/1998	3/29/2004
Inactive	Ameritas Variable Life Insurance Company	300665	Agent - Life	4/13/1998	3/29/2004
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021
Inactive	Assurance Company of America	300432	Agent - General Lines	11/3/1988	3/31/1996
Inactive	Assurity Life Insurance Company	301099	Agent - Health	1/29/2017	5/23/2017
Inactive	Assurity Life Insurance Company	301099	Agent - Life	1/29/2017	5/23/2017
Inactive	Athene Annuity and Life Company	301893	Agent - Life	9/7/2010	9/6/2012
Inactive	BCS Insurance Company	300294	Agent - Casualty	7/6/2004	4/3/2008
Inactive	BCS Insurance Company	300294	Agent - Health	7/6/2004	4/3/2008
Inactive	BCS Insurance Company	300294	Agent - Property	7/6/2004	4/3/2008
Inactive	Bankers United Life Assurance Company	300296	Agent - Health	7/1/1997	9/15/1998
Inactive	Bankers United Life Assurance Company	300296	Agent - Life	7/1/1997	9/15/1998
Active	Banner Life Insurance Company	301696	Agent - Life	9/1/2010
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	6/27/2001	12/22/2011
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	6/27/2001	12/22/2011
Inactive	Blackboard Insurance Company	301640	Agent - General Lines	11/3/1988	3/31/1996
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Health	12/29/1997	9/30/2003
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Life	12/29/1997	9/30/2003
Active	Brighthouse Life Insurance Company	301829	Agent - Health	11/14/2014
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	11/14/2014	1/26/2018
Inactive	C.M. Life Insurance Company	301335	Agent - Health	4/23/1997	1/8/2004
Inactive	C.M. Life Insurance Company	301335	Agent - Life	4/23/1997	1/8/2004
Active	CIGNA Dental Health of Kentucky, Inc.	300904	Agent - Health	5/9/2018
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	5/9/2018
Active	CIGNA Health & Life Insurance Company	301783	Agent - Life	5/9/2018
Inactive	Celtic Insurance Company	300877	Agent - Health	1/24/1994	3/31/1997
Inactive	Celtic Insurance Company	300877	Agent - Life	1/24/1994	3/31/1997
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	8/25/1997	1/6/2003
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	3/10/2005	4/1/2007
Inactive	Cigna National Health Insurance Company	300235	Agent - Health	3/7/1991	3/31/1997
Inactive	Cigna National Health Insurance Company	300235	Agent - Life	3/7/1991	3/31/1997
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Health	8/10/2012	12/19/2016
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Life	8/10/2012	12/19/2016
Active	Colonial Life and Accident Insurance Company	300846	Agent - Health	2/27/2006
Active	Colonial Life and Accident Insurance Company	300846	Agent - Life	2/27/2006
Inactive	Commonwealth Annuity and Life Insurance Company	300798	Agent - Health	8/12/1999	5/30/2006
Inactive	Commonwealth Annuity and Life Insurance Company	300798	Agent - Life	8/12/1999	5/30/2006
Inactive	Commonwealth Annuity and Life Insurance Company	300798	Agent - Variable Life and Variable Annuities	7/2/2001	5/30/2006
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	4/9/2010	12/13/2016
Active	CompBenefits Insurance Company	301864	Agent - Health	11/4/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Life	4/9/2010	7/2/2013
Inactive	Companion Life Insurance Company	300191	Agent - Health	8/13/2001	1/13/2022
Active	Companion Life Insurance Company	300191	Agent - Life	8/13/2001
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	7/23/2001	6/11/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	7/23/2001	6/11/2014
Inactive	Continental Casualty Company	301019	Agent - Health	4/13/2000	6/12/2006
Inactive	Continental Insurance Company (The)	301242	Agent - Casualty	8/15/2000	12/27/2001
Inactive	Continental Insurance Company (The)	301242	Agent - General Lines	9/29/1980	8/15/2000
Inactive	Continental Insurance Company (The)	301242	Agent - Property	8/15/2000	12/27/2001
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	1/21/2021
Active	Dental Care Plus Inc.	301495	Agent - Health	2/28/2019
Active	Dental Concern Inc. (The)	301641	Agent - Health	3/12/2021
Inactive	DentiCare, Inc.	300655	Agent - Health	3/1/2001	11/1/2005
Inactive	DentiCare, Inc.	300655	Agent - Prepaid Dental Plan	3/19/1996	3/1/2001
Inactive	EMC National Life Company	300388	Agent - Life	9/23/2002	11/30/2007
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Health	3/23/2004	4/17/2008
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Life	2/4/2013	2/5/2015
Inactive	Empower Annuity Insurance Company of America	300259	Agent - Variable Life and Variable Annuities	2/4/2013	2/5/2015
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	8/20/2010	11/6/2012
Inactive	Encompass Indemnity Company	546376	Agent - Property	8/20/2010	11/6/2012
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	8/20/2010	11/6/2012
Inactive	Encompass Insurance Company of America	556578	Agent - Property	8/20/2010	11/6/2012
Inactive	Equitable Financial Life Insurance Company of America	301772	Agent - Health	6/16/2017	12/11/2022
Inactive	Equitable Financial Life Insurance Company of America	301772	Agent - Life	6/16/2017	12/11/2022
Inactive	Equitable Financial Life Insurance Company of America	301772	Agent - Variable Life and Variable Annuities	6/18/2004	12/10/2010
Inactive	Equitable Life Insurance Company of Iowa	301633	Agent - Life	6/3/1997	1/1/2004
Inactive	Equitable Life Insurance Company of Iowa	301633	Agent - Variable Life and Variable Annuities	3/21/2001	1/1/2004
Inactive	FMH Ag Risk Insurance Company	300425	Agent - Health	1/21/1992	3/31/2002
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	2/13/2014	4/2/2020
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	2/13/2014	4/2/2020
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	11/8/2017
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	11/8/2017
Inactive	First Colony Life Insurance Company	301179	Agent - Life	10/2/1987	1/1/2007
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	11/23/2008	7/23/2010
Inactive	First National Insurance Company of America	301690	Agent - General Lines	11/2/1990	3/31/1996
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	9/25/1997	12/24/2008
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	9/25/1997	12/24/2008
Inactive	General American Life Insurance Company	300280	Agent - Health	10/13/1993	5/30/2000
Inactive	General American Life Insurance Company	300280	Agent - Life	10/13/1993	5/30/2000
Inactive	General Insurance Company of America	300261	Agent - General Lines	11/2/1990	3/31/1996
Inactive	Genworth Life Insurance Company	300623	Agent - Health	4/22/2014	12/14/2016
Inactive	Genworth Life Insurance Company	300623	Agent - Life	4/22/2014	12/14/2016
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	3/30/2009
Active	Golden Rule Insurance Company	301943	Agent - Health	6/29/2017
Active	Golden Rule Insurance Company	301943	Agent - Life	6/29/2017
Active	Guardian Life Insurance Company of America	301316	Agent - Health	12/7/1987
Active	Guardian Life Insurance Company of America	301316	Agent - Life	12/7/1987
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	8/15/2000	11/10/2009
Inactive	Hartford Accident and Indemnity Company	301917	Agent - General Lines	4/10/1985	8/15/2000
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	8/15/2000	11/10/2009
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	8/15/2000	11/10/2009
Inactive	Hartford Casualty Insurance Company	301332	Agent - General Lines	4/10/1985	8/15/2000
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	8/15/2000	11/10/2009
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	8/15/2000	11/10/2009
Inactive	Hartford Fire Insurance Company	300628	Agent - General Lines	4/10/1985	8/15/2000
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	8/15/2000	11/10/2009
Inactive	Hartford Life Group Insurance Company	301708	Agent - Health	9/16/2002	12/31/2006
Inactive	Hartford Life Group Insurance Company	301708	Agent - Life	9/16/2002	12/31/2006
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	12/13/2012
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	12/13/2012
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	8/15/2000	11/10/2009
Inactive	Hartford Underwriters Insurance Company	301064	Agent - General Lines	9/12/1989	8/15/2000
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	8/15/2000	11/10/2009
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	3/31/2021
Active	Humana Health Plan of Ohio Inc.	301565	Agent - Health	3/31/2021
Active	Humana Health Plan, Inc.	300142	Agent - Health	4/20/2021
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	9/18/1997	3/1/2001
Active	Humana Insurance Company	301104	Agent - Health	5/7/1996
Active	Humana Insurance Company	301104	Agent - Life	5/7/1996
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	3/12/2021
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	3/12/2021
Active	Humana Medical Plan, Inc.	801568	Agent - Health	3/31/2021
Active	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	3/31/2021
Inactive	HumanaDental Insurance Company	301457	Agent - Health	4/10/2012	5/13/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Life	4/10/2012	5/13/2013
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	6/28/1988	4/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	6/28/1988	4/2/2007
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	8/12/2002	6/7/2008
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	8/12/2002	6/7/2008
Inactive	John Hancock Life Insurance Company	300821	Agent - Variable Life and Variable Annuities	8/12/2002	6/7/2008
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	8/6/1999	5/28/2010
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	5/14/2021
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Variable Life and Variable Annuities	5/14/2021
Inactive	Kanawha Insurance Company	300127	Agent - Health	6/18/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	6/18/2015	10/22/2015
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	10/3/2013	10/29/2015
Inactive	Keyport Life Insurance Company	300319	Agent - Health	9/1/1981	3/31/1997
Inactive	Keyport Life Insurance Company	300319	Agent - Life	9/1/1981	3/31/1997
Inactive	LifeSecure Insurance Company	301629	Agent - Health	2/20/2013	9/3/2015
Inactive	LifeUSA Insurance Company	300386	Agent - Life	11/27/1991	3/6/1996
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	9/15/2004	7/14/2014
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	9/15/2004	7/14/2014
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	4/7/1995
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	4/7/1995
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Variable Life and Variable Annuities	5/31/2001
Inactive	MEGA Life and Health Insurance Company (The)	300751	Agent - Health	4/26/2002	3/28/2007
Inactive	MEGA Life and Health Insurance Company (The)	300751	Agent - Life	4/26/2002	3/28/2007
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	6/22/2011	3/12/2012
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Life	6/22/2011	3/12/2012
Inactive	Manufacturers Life Insurance Company of America (The)	300618	Agent - Health	8/6/1999	12/31/2001
Inactive	Manufacturers Life Insurance Company of America (The)	300618	Agent - Life	8/6/1999	12/31/2001
Inactive	Manufacturers Life Insurance Company of North America	301899	Agent - Life	3/17/2000	1/22/2002
Inactive	Maryland Casualty Company	301719	Agent - General Lines	11/3/1988	3/31/1996
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	5/13/2019	8/29/2023
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	8/14/2018	8/29/2023
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Variable Life and Variable Annuities	5/13/2019	8/29/2023
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	4/20/2009	11/14/2014
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	4/20/2009	11/14/2014
Inactive	Metropolitan Insurance and Annuity Company	301239	Agent - Health	2/17/1995	3/31/1997
Inactive	Metropolitan Insurance and Annuity Company	301239	Agent - Life	2/17/1995	3/31/1997
Active	Metropolitan Life Insurance Company	301948	Agent - Health	12/27/2012
Active	Metropolitan Life Insurance Company	301948	Agent - Life	12/27/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Variable Life and Variable Annuities	6/29/2016	10/17/2016
Inactive	Midland Life Insurance Company (The)	300310	Agent - Health	10/1/1997	3/31/2001
Inactive	Midland Life Insurance Company (The)	300310	Agent - Life	10/1/1997	3/31/2001
Active	Minnesota Life Insurance Company	300488	Agent - Health	3/11/2015
Active	Minnesota Life Insurance Company	300488	Agent - Life	3/11/2015
Active	Minnesota Life Insurance Company	300488	Agent - Variable Life and Variable Annuities	3/11/2015
Active	Mutual of Omaha Insurance Company	301012	Agent - Health	7/10/1996
Inactive	Nassau Life Insurance Company	301406	Agent - Health	4/26/1989	12/30/1998
Inactive	Nassau Life Insurance Company	301406	Agent - Life	4/26/1989	12/30/1998
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	10/30/2014	8/5/2020
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	2/6/2013
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	10/9/2015	5/26/2021
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	10/9/2015	5/26/2021
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Health	12/6/1999	2/23/2005
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	12/6/1999	9/22/2003
Inactive	North American Company for Life and Health Insurance	300291	Agent - Health	9/29/2015	10/5/2015
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	6/28/2010	10/5/2015
Inactive	North American Company for Life and Health Insurance	300291	Agent - Variable Life and Variable Annuities	9/29/2015	10/5/2015
Inactive	Omaha Insurance Company	751908	Agent - Health	4/27/2012	8/8/2018
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	8/6/2005	7/17/2012
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	8/6/2005	7/17/2012
Inactive	Pacific Life Insurance Company	301848	Agent - Health	8/14/2013	11/21/2018
Inactive	Pacific Life Insurance Company	301848	Agent - Life	10/17/2010	11/21/2018
Inactive	Pacific Life Insurance Company	301848	Agent - Variable Life and Variable Annuities	10/17/2010	11/21/2018
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	2/2/1995	11/10/2004
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	2/2/1995	11/10/2004
Inactive	Paul Revere Protective Life Insurance Company (The)	301428	Agent - Health	2/2/1995	4/23/1999
Inactive	Paul Revere Protective Life Insurance Company (The)	301428	Agent - Life	2/2/1995	4/23/1999
Active	Penn Insurance and Annuity Company	300712	Agent - Life	3/5/2021
Active	Penn Mutual Life Insurance Company	301394	Agent - Life	3/5/2021
Active	Principal Life Insurance Company	300129	Agent - Health	4/25/2011
Active	Principal Life Insurance Company	300129	Agent - Life	4/25/2011
Active	Principal Life Insurance Company	300129	Agent - Variable Life and Variable Annuities	4/25/2011
Inactive	Professional Insurance Company	301281	Agent - Health	1/23/1992	3/31/1997
Inactive	Professional Insurance Company	301281	Agent - Life	1/23/1992	3/31/1997
Inactive	Protective Life Insurance Company	300638	Agent - Health	2/13/2015	11/23/2017
Inactive	Protective Life Insurance Company	300638	Agent - Life	2/13/2015	11/23/2017
Inactive	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities	2/13/2015	11/23/2017
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	4/20/1994	12/30/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	4/20/1994	12/30/2009
Inactive	Pruco Life Insurance Company	300954	Agent - Life	2/2/2022	12/21/2022
Inactive	Pruco Life Insurance Company	300954	Agent - Variable Life and Variable Annuities	2/2/2022	12/21/2022
Active	Prudential Insurance Company of America	300784	Agent - Health	9/17/2007
Active	Prudential Insurance Company of America	300784	Agent - Life	9/17/2007
Inactive	RLI Insurance Company	301217	Agent - Casualty	8/15/2000	3/10/2004
Inactive	RLI Insurance Company	301217	Agent - General Lines	10/22/1986	8/15/2000
Inactive	RLI Insurance Company	301217	Agent - Property	8/15/2000	3/10/2004
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	11/12/2010	2/3/2017
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	11/12/2010	2/3/2017
Inactive	ReliaStar Life Insurance Company	301712	Agent - Variable Life and Variable Annuities	11/12/2010	2/3/2017
Active	Reliance Standard Life Insurance Company	300584	Agent - Health	7/7/2004
Active	Reliance Standard Life Insurance Company	300584	Agent - Life	7/7/2004
Inactive	SAFECO Insurance Company of America	300159	Agent - General Lines	11/2/1990	3/31/1996
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - General Lines	11/2/1990	3/31/1996
Inactive	SAFECO National Insurance Company	300989	Agent - General Lines	2/13/1992	3/31/1996
Inactive	Security Life Insurance Company of America	300936	Agent - Health	7/28/2015	12/31/2016
Inactive	Security Life Insurance Company of America	300936	Agent - Life	7/28/2015	12/31/2016
Inactive	Security Life of Denver Insurance Company	300648	Agent - Health	11/12/2010	9/29/2012
Inactive	Security Life of Denver Insurance Company	300648	Agent - Life	11/12/2010	9/29/2012
Inactive	Security Life of Denver Insurance Company	300648	Agent - Variable Life and Variable Annuities	11/12/2010	9/29/2012
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Health	6/22/1994	10/1/2003
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Life	6/22/1994	10/1/2003
Inactive	SeeChange Health Insurance Company	301115	Agent - Health	8/20/1992	11/9/1996
Inactive	SeeChange Health Insurance Company	301115	Agent - Life	8/20/1992	11/9/1996
Inactive	Shenandoah Life Insurance Company	300130	Agent - Health	8/23/2006	3/31/2009
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	8/23/2006	3/31/2009
Inactive	Standard Insurance Company	300185	Agent - Health	1/4/2007	12/31/2013
Inactive	Standard Insurance Company	300185	Agent - Life	1/4/2007	12/31/2013
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	6/10/2009	12/26/2018
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	6/10/2009	12/26/2018
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	6/29/2016	9/5/2020
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	6/29/2016	9/5/2020
Active	Sun Life Assurance Company of Canada	301811	Agent - Health	6/27/2012
Active	Sun Life Assurance Company of Canada	301811	Agent - Life	6/27/2012
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Health	9/2/1997	8/22/2011
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Life	9/2/1997	8/22/2011
Inactive	Symetra Life Insurance Company	301691	Agent - Health	4/23/2013	6/17/2024
Inactive	Symetra Life Insurance Company	301691	Agent - Life	4/23/2013	6/17/2024
Inactive	Symetra Life Insurance Company	301691	Agent - Variable Life and Variable Annuities	5/31/2001	12/28/2004
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	7/12/1999	7/24/2009
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	7/12/1999	7/24/2009
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Variable Life and Variable Annuities	5/31/2001	7/24/2009
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	7/12/1999	7/24/2009
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	7/12/1999	7/24/2009
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Variable Life and Variable Annuities	5/31/2001	7/24/2009
Inactive	The Savings Bank Mutual Life Insurance Company of Massachusetts	690290	Agent - Life	10/28/2011	12/19/2014
Inactive	Time Insurance Company	300683	Agent - Health	8/26/2014	11/25/2019
Inactive	Time Insurance Company	300683	Agent - Life	8/26/2014	11/25/2019
Active	Transamerica Life Insurance Company	300571	Agent - Health	3/12/2010
Active	Transamerica Life Insurance Company	300571	Agent - Life	3/12/2010
Active	Transamerica Life Insurance Company	300571	Agent - Variable Life and Variable Annuities	12/15/2011
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	8/29/2011	12/18/2015
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	8/29/2011	12/18/2015
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	8/15/2000	1/8/2016
Inactive	Travelers Property Casualty Company of America	301649	Agent - General Lines	3/30/2000	8/15/2000
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	8/15/2000	1/8/2016
Inactive	Trustmark Insurance Company	300317	Agent - Health	12/12/2001	5/15/2003
Inactive	Trustmark Insurance Company	300317	Agent - Life	12/12/2001	5/15/2003
Active	Trustmark Life Insurance Company	301286	Agent - Health	12/20/2022
Active	Trustmark Life Insurance Company	301286	Agent - Life	12/20/2022
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	8/15/2000	11/10/2009
Inactive	Twin City Fire Insurance Company	300721	Agent - General Lines	4/10/1985	8/15/2000
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	8/15/2000	11/10/2009
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Health	3/21/1996	3/31/1997
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	3/21/1996	3/31/1997
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	7/3/2000	12/30/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	7/3/2000	12/30/2009
Inactive	Union Central Life Insurance Company	300307	Agent - Health	11/9/2006	3/14/2011
Inactive	Union Central Life Insurance Company	300307	Agent - Life	11/9/2006	3/14/2011
Inactive	Union Security Insurance Company	301844	Agent - Health	10/1/1991	1/8/2015
Inactive	Union Security Insurance Company	301844	Agent - Life	10/1/1991	1/8/2015
Inactive	United Concordia Dental Plans of Kentucky Inc.	301923	Agent - Health	3/1/2001	12/29/2006
Inactive	United Concordia Dental Plans of Kentucky Inc.	301923	Agent - Prepaid Dental Plan	10/24/1996	3/1/2001
Inactive	United Concordia Life and Health Insurance Company	301220	Agent - Health	6/12/2001	12/29/2006
Inactive	United Teacher Associates Insurance Company	300747	Agent - Health	10/1/2001	1/8/2003
Inactive	United Teacher Associates Insurance Company	300747	Agent - Life	10/1/2001	1/8/2003
Inactive	United World Life Insurance Company	300532	Agent - Health	6/1/2007	12/15/2010
Active	United of Omaha Life Insurance Company	300156	Agent - Health	10/11/1996
Active	United of Omaha Life Insurance Company	300156	Agent - Life	10/11/1996
Active	United of Omaha Life Insurance Company	300156	Agent - Variable Life and Variable Annuities	3/7/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	1/11/2022	3/27/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	1/11/2022	3/27/2023
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/12/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/12/2015	11/4/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/18/2015	2/14/2017
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health Maintenance Organization	2/21/1998	3/1/2001
Inactive	Unum Insurance Company	301499	Agent - Health	2/2/1995	10/8/2021
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	3/21/2001	8/26/2008
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Variable Life and Variable Annuities	5/31/2001	8/26/2008
Active	Washington National Insurance Company	300587	Agent - Health	11/9/2015
Active	Washington National Insurance Company	300587	Agent - Life	11/9/2015
Inactive	West Coast Life Insurance Company	301607	Agent - Health	9/1/2011	9/18/2012
Inactive	West Coast Life Insurance Company	301607	Agent - Life	9/1/2011	9/18/2012
Inactive	Wilcac Life Insurance Company	301573	Agent - Health	9/16/2002	6/12/2006
Inactive	Wilcac Life Insurance Company	301573	Agent - Life	9/16/2002	6/12/2006
Inactive		300277	Agent - Health	7/3/1996	1/1/2007
Inactive		300277	Agent - Life	7/3/1996	1/1/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Designated Agent Company Inc.	681257	Agent - Health	12/11/2013
Active	Designated Agent Company Inc.	681257	Agent - Life	12/11/2013
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Active	Planchoice Inc.	400482	Agent - Health	3/5/2003
Active	Planchoice Inc.	400482	Agent - Life	3/5/2003
Active	R.H. Clarkson Financial Services Inc.	398870	Agent - Health	3/12/1996
Active	R.H. Clarkson Financial Services Inc.	398870	Agent - Life	3/12/1996
Active	R.H. Clarkson Financial Services Inc.	398870	Administrator - Not Applicable	10/24/2011
Inactive	Raymond James Insurance Group, Inc.	398342	Agent - Health	6/13/2003	3/1/2005
Inactive	Raymond James Insurance Group, Inc.	398342	Agent - Life	6/13/2003	3/1/2005
Inactive	Raymond James Insurance Group, Inc.	398342	Agent - Variable Life and Variable Annuities	6/13/2003	3/1/2005
Inactive	Robert H. Clarkson Insurance Agency	400771	Agent - General Lines	9/22/1997	8/15/2000
Inactive	Robert H. Clarkson Insurance Agency	400771	Agent - Property	11/3/2015	9/5/2020
Inactive	Robert H. Clarkson Insurance Agency	400771	Agent - Casualty	11/3/2015	9/5/2020