DEPARTMENT OF INSURANCE

Affiliations

Name	Mitchum, Richard Allen	DOIID	328102	NAIC NPN	1467063

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	10/20/2006	3/1/2023
Active	Non Resident	Agent	Casualty	6/5/2017		3/31/2027
Active	Non Resident	Agent	Life	6/12/2017		3/31/2027
Active	Non Resident	Agent	Health	6/12/2017		3/31/2027
Active	Non Resident	Agent	Property	6/5/2017		3/31/2027
Inactive	Resident	Agent	Health Maintenance Organization	10/4/1989	3/1/2001
Inactive	Non Resident	Life & Health Consultant	Not Applicable	6/7/1995	2/22/2023
Inactive	Resident	Solicitor	General Lines	4/11/1995	7/14/2000
* 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	01/15/2025	03/31/2025	03/21/2025	03/21/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	5/25/2006	4/1/2011
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	5/25/2006	4/1/2011
Inactive	American General Life Insurance Company	301585	Agent - Health	12/16/2019	12/23/2019
Inactive	American General Life Insurance Company	301585	Agent - Life	12/16/2019	12/23/2019
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	5/14/1998	9/29/2005
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	5/14/1998	9/29/2005
Inactive	American Investors Life Insurance Company, Inc.	301358	Agent - Life	11/27/2006	5/25/2009
Inactive	American United Life Insurance Company	300498	Agent - Health	4/17/2020	11/15/2023
Inactive	American United Life Insurance Company	300498	Agent - Life	4/17/2020	11/15/2023
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	4/14/2025
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	2/20/1990	3/1/2001
Inactive	Anthem Life Insurance Company	301209	Agent - Health	5/8/2020	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/12/2020	4/15/2025
Inactive	Athene Annuity and Life Company	301893	Agent - Life	9/19/2008	5/29/2009
Inactive	Avemco Insurance Company	300669	Agent - Health	8/8/2002	6/15/2005
Inactive	Banner Life Insurance Company	301696	Agent - Life	9/9/2016	4/1/2017
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	1/12/2019	10/5/2021
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	1/12/2019	10/5/2021
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	4/17/1992	4/15/2005
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	4/17/1992	4/15/2005
Inactive	CIGNA Dental Health of Kentucky, Inc.	300904	Agent - Health	2/16/2007	4/1/2011
Inactive	Clarica Life Insurance Company - U.S.	300207	Agent - Health	11/21/1991	3/31/1997
Inactive	Clarica Life Insurance Company - U.S.	300207	Agent - Life	11/21/1991	3/31/1997
Inactive	Companion Life Insurance Company	300191	Agent - Health	5/17/2007	4/1/2011
Inactive	Companion Life Insurance Company	300191	Agent - Life	5/17/2007	4/1/2011
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	2/16/2007	4/1/2011
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	2/16/2007	4/1/2011
Inactive	Continental Casualty Company	301019	Agent - Health	8/21/1992	12/18/2002
Inactive	Dearborn Life Insurance Company	300401	Agent - Health	1/6/2009	4/6/2011
Inactive	Dearborn Life Insurance Company	300401	Agent - Life	1/6/2009	4/6/2011
Active	Equitable Financial Life Insurance Company of America	301772	Agent - Health	6/21/2022
Active	Equitable Financial Life Insurance Company of America	301772	Agent - Life	6/21/2022
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	3/21/2024
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	2/27/2019	12/1/2022
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	2/27/2019	12/1/2022
Inactive	First Colony Life Insurance Company	301179	Agent - Life	7/22/2005	1/1/2007
Inactive	General American Life Insurance Company	300280	Agent - Health	12/11/1991	11/25/1996
Inactive	General American Life Insurance Company	300280	Agent - Life	12/11/1991	11/25/1996
Inactive	Genworth Life Insurance Company	300623	Agent - Health	8/8/2000	1/6/2006
Inactive	Genworth Life Insurance Company	300623	Agent - Life	8/8/2000	1/6/2006
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	5/5/2009	4/1/2011
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	4/1/2011
Active	Gerber Life Insurance Company	300529	Agent - Health	5/3/2024
Active	Gerber Life Insurance Company	300529	Agent - Life	5/3/2024
Inactive	Guarantee Life Insurance Company	301560	Agent - Health	5/9/1995	9/8/2000
Inactive	Guarantee Life Insurance Company	301560	Agent - Life	5/9/1995	9/8/2000
Active	Guardian Life Insurance Company of America	301316	Agent - Health	1/12/2019
Active	Guardian Life Insurance Company of America	301316	Agent - Life	1/12/2019
Inactive	HCC Life Insurance Company	301827	Agent - Health	6/5/2012	4/1/2013
Inactive	HCC Life Insurance Company	301827	Agent - Life	6/5/2012	4/1/2013
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	2/9/2006	4/1/2011
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	2/9/2006	4/1/2011
Inactive	Health Resources Inc.	301210	Agent - Health	11/8/2019	12/12/2022
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	5/6/2009	4/1/2011
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	10/4/1989	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	5/6/2009	4/1/2011
Inactive	Humana Insurance Company	301104	Agent - Life	5/6/2009	4/1/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/6/2009	4/1/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	5/6/2009	4/1/2011
Inactive	Indianapolis Life Insurance Company	301381	Agent - Life	9/25/2007	10/1/2008
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	9/8/2000	7/2/2007
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	9/8/2000	7/2/2007
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	11/10/1994	4/28/1997
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	11/10/1994	4/28/1997
Inactive	John Alden Life Insurance Company	300573	Agent - Health	10/12/1989	3/31/1997
Inactive	John Alden Life Insurance Company	300573	Agent - Life	10/12/1989	3/31/1997
Inactive	Kanawha Insurance Company	300127	Agent - Health	5/6/2009	4/1/2011
Inactive	Kanawha Insurance Company	300127	Agent - Life	5/6/2009	4/1/2011
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Health	3/11/2002	1/23/2008
Inactive	Lafayette Life Insurance Company (The)	301039	Agent - Life	3/11/2002	1/23/2008
Inactive	Life Insurance Company of Georgia	300267	Agent - Health	12/11/1996	4/21/2000
Inactive	Life Insurance Company of Georgia	300267	Agent - Life	12/11/1996	4/21/2000
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	12/30/1992	3/31/1997
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	7/5/2018
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	7/5/2018
Active	Markel Insurance Company	301475	Agent - Health	4/5/2024
Inactive	Midland Life Insurance Company (The)	300310	Agent - Health	12/10/1998	3/31/2001
Inactive	Midland Life Insurance Company (The)	300310	Agent - Life	12/10/1998	3/31/2001
Inactive	Midland National Life Insurance Company	300923	Agent - Health	2/8/2000	8/7/2001
Inactive	Midland National Life Insurance Company	300923	Agent - Life	7/20/2005	8/22/2007
Inactive	Nassau Life Insurance Company	301406	Agent - Health	8/23/1995	12/14/2004
Inactive	Nassau Life Insurance Company	301406	Agent - Life	8/23/1995	12/14/2004
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	5/31/2018
Inactive	Old Republic Life Insurance Company	301214	Agent - Health	4/19/1991	12/15/2004
Inactive	Old Republic Life Insurance Company	301214	Agent - Life	4/19/1991	12/15/2004
Inactive	PHL Variable Insurance Company	300525	Agent - Health	8/9/1995	12/9/2008
Inactive	PHL Variable Insurance Company	300525	Agent - Life	8/9/1995	2/22/2007
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	7/7/1989	11/10/2004
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	7/7/1989	11/10/2004
Inactive	Pruco Life Insurance Company	300954	Agent - Health	1/30/2007	4/1/2011
Inactive	Pruco Life Insurance Company	300954	Agent - Life	1/30/2007	4/1/2011
Inactive	QBE Insurance Corporation	300515	Agent - Health	6/22/2010	4/1/2011
Inactive	Reassure America Life Insurance Company	301902	Agent - Health	10/25/2000	9/16/2004
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	10/25/2000	9/16/2004
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Health	11/1/2013	4/1/2015
Inactive	Reliance Standard Life Insurance Company	300584	Agent - Life	11/1/2013	4/1/2015
Inactive	Sagicor Life Insurance Company	300459	Agent - Life	12/30/2020	9/13/2022
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Health	11/29/1990	3/31/1997
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Life	11/29/1990	3/31/1997
Inactive	Shenandoah Life Insurance Company	300130	Agent - Health	8/21/1990	12/19/2001
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	8/21/1990	12/19/2001
Active	SiriusPoint America Insurance Company	301148	Agent - Casualty	2/9/2022
Active	SiriusPoint America Insurance Company	301148	Agent - Health	4/27/2020
Active	SiriusPoint America Insurance Company	301148	Agent - Property	2/9/2022
Inactive	Southland Life Insurance Company	301175	Agent - Life	2/21/1998	2/25/2003
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Health	4/8/1992	3/31/1997
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Life	4/8/1992	3/31/1997
Inactive	SunAmerica Annuity and Life Assurance Company	301930	Agent - Health	7/1/1993	3/31/1997
Inactive	SunAmerica Annuity and Life Assurance Company	301930	Agent - Life	7/1/1993	3/31/1997
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	1/25/1990	3/31/1997
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	1/25/1990	3/31/1997
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	6/25/1999	11/15/2004
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	6/25/1999	11/15/2004
Inactive	Trustmark Insurance Company	300317	Agent - Health	4/26/1991	3/31/1997
Inactive	Trustmark Insurance Company	300317	Agent - Life	4/26/1991	3/31/1997
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Health	10/1/2001	9/27/2007
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	10/1/2001	9/27/2007
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	9/7/1995	5/24/2001
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	9/7/1995	5/24/2001
Active	United of Omaha Life Insurance Company	300156	Agent - Health	7/4/2018
Active	United of Omaha Life Insurance Company	300156	Agent - Life	7/4/2018
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	9/8/1995	3/31/1997
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	9/8/1995	3/31/1997
Inactive	West Coast Life Insurance Company	301607	Agent - Life	5/3/2007	12/15/2008
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Health	11/7/1996	4/17/1998
Inactive	Western Reserve Life Assurance Company of Ohio	300760	Agent - Life	11/7/1996	4/17/1998
Inactive	Wilco Life Insurance Company	300122	Agent - Health	11/9/1999	4/27/2001
Inactive	Wilco Life Insurance Company	300122	Agent - Life	11/9/1999	4/27/2001

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Louisville Inc.	401252	Agent - Health	7/1/1993	2/28/2003
Inactive	Acordia of Louisville Inc.	401252	Agent - Life	7/1/1993	2/28/2003
Inactive	Automobile Business Management Inc.	399520	Agent - Health	2/8/1990	3/31/1997
Inactive	Automobile Business Management Inc.	399520	Agent - Life	2/8/1990	3/31/1997
Active	Designated Agent Company Inc.	681257	Agent - Health	7/4/2018
Active	Designated Agent Company Inc.	681257	Agent - Life	1/12/2019
Denied	Epic Ins Solutions Agency Llc	961527	Agent - Health
Denied	Epic Ins Solutions Agency Llc	961527	Agent - Life
Denied	Epic Ins Solutions Agency Llc	961527	Agent - Casualty
Denied	Epic Ins Solutions Agency Llc	961527	Agent - Property
Denied	Epic Ins Solutions LLC	802896	Agent - Health
Denied	Epic Ins Solutions LLC	802896	Agent - Life
Denied	Epic Ins Solutions LLC	802896	Agent - Casualty
Denied	Epic Ins Solutions LLC	802896	Agent - Property
Active	Fifth Third Insurance Agency Inc	399341	Agent - Health	11/12/2018
Active	Fifth Third Insurance Agency Inc	399341	Agent - Life	11/12/2018
Denied	Fifth Third Insurance Agency Inc	399341	Agent - Casualty
Denied	Fifth Third Insurance Agency Inc	399341	Agent - Property
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	3/31/1997
Inactive	Midwestern Insurance Alliance Inc.	401257	Agent - Health	2/20/2004	4/1/2011
Inactive	Midwestern Insurance Alliance Inc.	401257	Agent - Life	2/20/2004	4/1/2011
Inactive	Preferred Health Plan Inc.	397836	Administrator - Not Applicable	1/9/2008	3/31/2016
Inactive	Stauffer Financial Services Inc.	400391	Agent - Health	2/9/1990	5/31/2004
Inactive	Stauffer Financial Services Inc.	400391	Agent - Life	2/9/1990	5/31/2004