DEPARTMENT OF INSURANCE
Affiliations
NameTolly, Michael JamesDOIID343216NAIC NPN1480165
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveResidentAgentHealth8/27/1987 5/31/2025
ActiveResidentAgentLife8/27/1987 5/31/2025
DeniedResidentAgentCasualty   
DeniedResidentAgentProperty   
InactiveResidentAgentHealth Maintenance Organization8/25/19973/1/2001 
InactiveResidentAgentPrepaid Dental Plan8/5/19993/1/2001 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent03/15/202505/31/2025   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAetna Health Inc. (PA)660717Agent - Health6/12/20177/7/2022
InactiveAetna Life Insurance Company301140Agent - Health6/12/20177/7/2022
InactiveAetna Life Insurance Company301140Agent - Life6/12/20177/7/2022
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Health4/15/20134/10/2019
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Life4/15/20134/10/2019
InactiveAmerican Fidelity Assurance Company301004Agent - Health2/7/20138/11/2016
InactiveAmerican Fidelity Assurance Company301004Agent - Life2/7/20138/11/2016
InactiveAmerican General Life Insurance Company301585Agent - Health2/4/20143/7/2014
InactiveAmerican General Life Insurance Company301585Agent - Life2/4/20143/7/2014
ActiveAmerican Heritage Life Insurance Company300272Agent - Health1/28/2011 
ActiveAmerican Heritage Life Insurance Company300272Agent - Life1/28/2011 
ActiveAmerican United Life Insurance Company300498Agent - Health2/3/2020 
ActiveAmerican United Life Insurance Company300498Agent - Life2/3/2020 
InactiveAmeritas Life Insurance Corporation300126Agent - Health7/19/199912/28/2012
InactiveAmeritas Life Insurance Corporation300126Agent - Life7/19/199912/28/2012
InactiveAssurity Life Insurance Company301099Agent - Health7/8/201412/12/2016
InactiveAssurity Life Insurance Company301099Agent - Life7/8/201412/12/2016
InactiveAthene Annuity & Life Assurance Company301798Agent - Health3/13/20002/23/2008
InactiveAthene Annuity & Life Assurance Company301798Agent - Life3/13/20002/23/2008
InactiveBerkshire Life Insurance Company of America300983Agent - Health8/15/20052/23/2008
InactiveBerkshire Life Insurance Company of America300983Agent - Life8/15/20052/23/2008
ActiveBoston Mutual Life Insurance Company300143Agent - Health10/7/2010 
ActiveBoston Mutual Life Insurance Company300143Agent - Life10/7/2010 
InactiveBrighthouse Life Insurance Company301829Agent - Health12/7/20072/9/2010
InactiveBrighthouse Life Insurance Company301829Agent - Life12/7/20072/9/2010
InactiveCIGNA Dental Health of Kentucky, Inc.300904Agent - Health3/2/20042/23/2008
InactiveCentre Life Insurance Company300341Agent - Health8/15/19953/31/1999
InactiveChase Insurance Life and Annuity Company300518Agent - Health8/19/19987/22/1999
InactiveChase Insurance Life and Annuity Company300518Agent - Life8/19/19987/22/1999
InactiveCompBenefits Dental, Inc.591692Agent - Health7/28/20093/14/2019
ActiveCompBenefits Insurance Company301864Agent - Health12/5/2019 
InactiveCompBenefits Insurance Company301864Agent - Life7/28/20097/2/2013
InactiveConnecticut General Life Insurance Company301333Agent - Health3/2/20043/7/2025
InactiveConnecticut General Life Insurance Company301333Agent - Life3/2/20043/7/2025
InactiveContinental American Insurance Company301700Agent - Health9/29/201112/30/2019
InactiveContinental American Insurance Company301700Agent - Life9/29/201112/30/2019
InactiveContinental General Insurance Company300691Agent - Health8/9/20181/25/2019
InactiveContinental General Insurance Company300691Agent - Life8/9/20181/25/2019
InactiveCoventry Health and Life Insurance Company301771Agent - Health6/12/20176/15/2022
Pending ReplacementDental Care Plus Inc.301495Agent - Health6/1/2015 
InactiveDental Concern Inc. (The)301641Agent - Health1/14/202112/12/2024
InactiveDentiCare, Inc.300655Agent - Health3/1/200111/1/2005
InactiveDentiCare, Inc.300655Agent - Prepaid Dental Plan8/5/19993/1/2001
InactiveEMC National Life Company300388Agent - Health5/5/20092/27/2017
InactiveEMC National Life Company300388Agent - Life5/5/20092/27/2017
InactiveEquitable Financial Life Insurance Company of America301772Agent - Life3/5/20042/23/2008
InactiveFidelity Life Association, A Legal Reserve Life Insurance Company300774Agent - Health8/19/19987/22/1999
InactiveFidelity Life Association, A Legal Reserve Life Insurance Company300774Agent - Life8/19/19987/22/1999
InactiveFidelity Security Life Insurance Company300466Agent - Health3/15/201812/11/2020
InactiveFidelity Security Life Insurance Company300466Agent - Life3/15/201812/11/2020
InactiveFirst Colony Life Insurance Company301179Agent - Life10/16/19957/19/2004
InactiveFirst Penn-Pacific Life Insurance Company301581Agent - Health5/17/20012/23/2008
InactiveFirst Penn-Pacific Life Insurance Company301581Agent - Life5/17/20012/23/2008
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health2/26/200810/4/2009
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life2/26/200810/4/2009
InactiveGrange Life Insurance Company300128Agent - Health9/19/20072/23/2008
InactiveGrange Life Insurance Company300128Agent - Life9/19/20072/23/2008
ActiveGuardian Life Insurance Company of America301316Agent - Health8/15/2005 
ActiveGuardian Life Insurance Company of America301316Agent - Life8/15/2005 
InactiveHCC Life Insurance Company301827Agent - Health9/23/20059/11/2007
InactiveHCC Life Insurance Company301827Agent - Life9/23/20059/11/2007
ActiveHartford Fire Insurance Company300628Agent - Health4/7/2020 
ActiveHartford Life and Accident Insurance Company300878Agent - Health10/19/2016 
ActiveHartford Life and Accident Insurance Company300878Agent - Life10/19/2016 
InactiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health12/31/202012/12/2024
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health12/31/202012/12/2024
InactiveHumana Health Plan, Inc.300142Agent - Health3/1/200112/12/2024
InactiveHumana Health Plan, Inc.300142Agent - Health Maintenance Organization8/25/19973/1/2001
InactiveHumana Insurance Company301104Agent - Health3/21/200712/12/2024
InactiveHumana Insurance Company301104Agent - Life3/21/200712/12/2024
InactiveHumana Insurance Company of Kentucky300826Agent - Health12/31/202012/12/2024
InactiveHumana Insurance Company of Kentucky300826Agent - Life12/31/202012/12/2024
InactiveHumana Medical Plan, Inc.801568Agent - Health12/31/202012/12/2024
InactiveHumana Wisconsin Health Organization Insurance Corporation830687Agent - Health12/31/202012/12/2024
InactiveHumanaDental Insurance Company301457Agent - Health3/7/20095/13/2013
InactiveHumanaDental Insurance Company301457Agent - Life3/7/20095/13/2013
InactiveJefferson-Pilot Life Insurance Company300379Agent - Health6/24/19966/22/1999
InactiveJefferson-Pilot Life Insurance Company300379Agent - Life6/24/19966/22/1999
InactiveKanawha Insurance Company300127Agent - Health4/11/20088/9/2018
InactiveKanawha Insurance Company300127Agent - Life4/11/20088/9/2018
InactiveLincoln Benefit Life Company301110Agent - Health1/16/20011/15/2004
InactiveLincoln Benefit Life Company301110Agent - Life1/16/20011/15/2004
ActiveLincoln National Life Insurance Company (The)301382Agent - Health11/11/2014 
ActiveLincoln National Life Insurance Company (The)301382Agent - Life11/11/2014 
InactiveMEGA Life and Health Insurance Company (The)300751Agent - Health1/30/20065/17/2007
InactiveMEGA Life and Health Insurance Company (The)300751Agent - Life1/30/20065/17/2007
InactiveMetLife Investors USA Insurance Company300845Agent - Health3/14/200611/19/2009
InactiveMetLife Investors USA Insurance Company300845Agent - Life3/14/200611/19/2009
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Health7/25/199512/7/2007
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Life7/25/199512/7/2007
InactiveMetropolitan Life Insurance Company301948Agent - Health2/24/200412/16/2014
InactiveMetropolitan Life Insurance Company301948Agent - Life2/24/200412/16/2014
InactiveMidland Life Insurance Company (The)300310Agent - Health6/15/19983/31/2001
InactiveMidland Life Insurance Company (The)300310Agent - Life6/15/19983/31/2001
ActiveMutual of Omaha Insurance Company301012Agent - Health8/11/2009 
InactiveNassau Life Insurance Company301406Agent - Health2/8/19893/31/1997
InactiveNassau Life Insurance Company301406Agent - Life2/8/19893/31/1997
ActiveNational Guardian Life Insurance Company300596Agent - Health6/24/2019 
InactiveNational Health Insurance Company300554Agent - Health6/21/19955/28/1996
InactiveNational Health Insurance Company300554Agent - Life6/21/19955/28/1996
ActiveNippon Life Insurance Company of America300446Agent - Health4/18/2017 
ActiveNippon Life Insurance Company of America300446Agent - Life4/18/2017 
InactivePaul Revere Life Insurance Company300971Agent - Health10/4/199912/11/2002
InactivePaul Revere Life Insurance Company300971Agent - Life10/4/199912/11/2002
InactivePhiladelphia American Life Insurance Company300178Agent - Health4/6/19943/31/1997
InactivePhiladelphia American Life Insurance Company300178Agent - Life4/6/19943/31/1997
ActivePrincipal Life Insurance Company300129Agent - Health3/13/2012 
ActivePrincipal Life Insurance Company300129Agent - Life3/13/2012 
ActivePrincipal National Life Insurance Company301926Agent - Life7/11/2013 
InactiveProtective Life Insurance Company300638Agent - Health1/1/200711/23/2009
InactiveProtective Life Insurance Company300638Agent - Life1/1/200711/23/2009
InactiveProvident Life and Accident Insurance Company301525Agent - Health2/2/20069/9/2015
InactiveProvident Life and Accident Insurance Company301525Agent - Life2/2/20069/9/2015
InactiveReassure America Life Insurance Company301902Agent - Health6/23/19999/20/2004
InactiveReassure America Life Insurance Company301902Agent - Life6/23/19999/20/2004
InactiveReliaStar Life Insurance Company301712Agent - Health1/23/200312/4/2004
InactiveReliaStar Life Insurance Company301712Agent - Life1/23/200312/4/2004
ActiveReliance Standard Life Insurance Company300584Agent - Health1/16/2015 
ActiveReliance Standard Life Insurance Company300584Agent - Life1/16/2015 
InactiveSecurity-Connecticut Life Insurance Company300316Agent - Health3/9/199310/1/2003
InactiveSecurity-Connecticut Life Insurance Company300316Agent - Life3/9/199310/1/2003
InactiveStandard Insurance Company300185Agent - Health3/24/20042/23/2008
InactiveStandard Insurance Company300185Agent - Life3/24/20042/23/2008
InactiveState Life Insurance Company301497Agent - Health7/10/20039/22/2008
InactiveState Life Insurance Company301497Agent - Life7/10/20039/22/2008
InactiveSun Life Assurance Company of Canada301811Agent - Health9/17/20048/28/2015
InactiveSun Life Assurance Company of Canada301811Agent - Life9/17/20048/28/2015
InactiveSun Life and Health Insurance Company (U.S.)300801Agent - Health7/25/20088/28/2015
InactiveSun Life and Health Insurance Company (U.S.)300801Agent - Life7/25/20088/28/2015
Pending ReplacementSuperior Dental Care Inc.300418Agent - Health5/12/2016 
ActiveTransamerica Life Insurance Company300571Agent - Health10/1/2020 
ActiveTransamerica Life Insurance Company300571Agent - Life10/1/2020 
InactiveTransamerica Premier Life Insurance Company300558Agent - Health10/24/199610/1/2020
InactiveTransamerica Premier Life Insurance Company300558Agent - Life10/24/199610/1/2020
InactiveU.S. Financial Life Insurance Company301812Agent - Health6/28/19958/12/2003
InactiveU.S. Financial Life Insurance Company301812Agent - Life6/28/199511/15/2002
InactiveUNUM Life Insurance Company of America300817Agent - Health2/12/20099/9/2015
InactiveUNUM Life Insurance Company of America300817Agent - Life2/12/20099/9/2015
InactiveUnion Security Insurance Company301844Agent - Health11/29/19952/23/2008
InactiveUnion Security Insurance Company301844Agent - Life11/29/19952/23/2008
InactiveUnited Concordia Dental Plans of Kentucky Inc.301923Agent - Health7/6/20012/23/2008
ActiveUnited Concordia Dental Plans, Inc.919872Agent - Health1/1/2018 
ActiveUnited Concordia Insurance Company903543Agent - Health1/1/2018 
InactiveUnited Concordia Life and Health Insurance Company301220Agent - Health7/6/20012/23/2008
ActiveUnited of Omaha Life Insurance Company300156Agent - Health8/11/2009 
ActiveUnited of Omaha Life Insurance Company300156Agent - Life8/11/2009 
InactiveUnitedHealthcare Insurance Company300946Agent - Health12/16/200312/14/2009
InactiveUnitedHealthcare Insurance Company300946Agent - Life12/16/200312/14/2009
InactiveUnitedHealthcare Life Insurance Company301517Agent - Health5/22/199712/6/1999
InactiveUnitedHealthcare Life Insurance Company301517Agent - Life5/22/199712/6/1999
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health12/16/200312/14/2009
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health12/16/200312/14/2009
InactiveWest Coast Life Insurance Company301607Agent - Life5/14/200911/16/2011
InactiveWoodmen Accident and Life Company300147Agent - Health6/11/19969/2/1997
InactiveWoodmen Accident and Life Company300147Agent - Life6/11/19969/2/1997
Inactive300277Agent - Health3/5/19971/1/2007
Inactive300277Agent - Life3/5/19971/1/2007
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAssuredpartners NL, LLC762387Agent - Life1/29/2018 
ActiveAssuredpartners NL, LLC762387Agent - Health1/29/2018 
ActiveDental Choice Agency Inc.398085Agent - Health7/30/2009 
InactiveDesignated Agent Company Inc.681257Agent - Life12/12/20132/11/2025
InactiveDesignated Agent Company Inc.681257Agent - Health12/12/20132/11/2025
InactiveHartfield Louisville, LLC659359Agent - Life7/11/20073/31/2019
InactiveHartfield Louisville, LLC659359Agent - Health7/11/20073/31/2019
InactiveWillis of Louisville, Inc.401313Agent - Life7/6/19897/3/2007
InactiveWillis of Louisville, Inc.401313Agent - Health7/6/19897/3/2007

© Commonwealth of Kentucky. All rights reserved.