DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Kelly, Thomas A	DOIID	320434	NAIC NPN	1338645

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	8/13/1998		5/31/2025
Active	Non Resident	Agent	Life	8/13/1998		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	CIGNA Health & Life Insurance Company	301783	Agent - Health	8/13/1998	4/9/2003
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Life	8/13/1998	4/9/2003
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	9/13/2005	11/16/2011
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	9/13/2005	11/16/2011
Inactive	Principal Life Insurance Company	300129	Agent - Health	10/28/1998	11/30/2009
Inactive	Principal Life Insurance Company	300129	Agent - Life	10/28/1998	11/30/2009
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	8/5/1999	9/28/2007
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	8/5/1999	9/28/2007
Inactive	Union Security Insurance Company	301844	Agent - Health	6/24/2002	1/9/2015
Inactive	Union Security Insurance Company	301844	Agent - Life	6/24/2002	1/9/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	1/3/2012	1/9/2015
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	1/3/2012	1/9/2015
Denied	Usi Insurance Services LLC	669260	Agent - Life
Denied	Usi Insurance Services LLC	669260	Agent - Health
Inactive	Wells Fargo Ins Services Of New York Inc	569345	Agent - Life	7/18/2007	1/5/2012
Inactive	Wells Fargo Ins Services Of New York Inc	569345	Agent - Health	7/18/2007	1/5/2012