DEPARTMENT OF INSURANCE

Affiliations

Name	Kelley, Timothy Odaniel	DOIID	362577	NAIC NPN	2801110

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/10/2018		3/31/2026
Active	Non Resident	Agent	Life	9/10/2018		3/31/2026
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	6/7/2007	3/31/2010
* 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
Active	Aetna Health Inc. (PA)	660717	Agent - Health	3/30/2020
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	3/23/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	3/30/2020
Inactive	American National Insurance Company	301861	Agent - Health	12/22/2008	3/31/2010
Inactive	American National Insurance Company	301861	Agent - Life	12/22/2008	3/31/2010
Inactive	American United Life Insurance Company	300498	Agent - Health	1/16/2008	3/31/2010
Inactive	American United Life Insurance Company	300498	Agent - Life	1/16/2008	3/31/2010
Inactive	American United Life Insurance Company	300498	Agent - Variable Life and Variable Annuities	1/16/2008	3/31/2010
Active	Ameritas Life Insurance Corporation	300126	Agent - Health	10/14/2021
Active	Ameritas Life Insurance Corporation	300126	Agent - Life	10/14/2021
Inactive	Ameritas Life Insurance Corporation	300126	Agent - Variable Life and Variable Annuities	1/29/2008	3/31/2010
Active	Arcadian Health Plan, Inc.	728196	Agent - Health	12/4/2023
Inactive	Athene Annuity & Life Assurance Company of New York	300724	Agent - Life	10/21/2002	3/31/2006
Inactive	Commonwealth Annuity and Life Insurance Company	300798	Agent - Health	12/30/1996	5/30/2006
Inactive	Commonwealth Annuity and Life Insurance Company	300798	Agent - Life	12/30/1996	5/30/2006
Inactive	Commonwealth Annuity and Life Insurance Company	300798	Agent - Variable Life and Variable Annuities	6/29/2001	5/30/2006
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	4/25/2008	3/31/2010
Inactive	CompBenefits Insurance Company	301864	Agent - Health	4/25/2008	3/31/2010
Inactive	CompBenefits Insurance Company	301864	Agent - Life	4/25/2008	3/31/2010
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	3/31/2010
Inactive	First Colony Life Insurance Company	301179	Agent - Health	7/19/2001	7/14/2004
Inactive	First Colony Life Insurance Company	301179	Agent - Life	7/19/2001	7/14/2004
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Health	6/15/2007	3/31/2010
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Life	6/15/2007	3/31/2010
Inactive	Fortitude Life Insurance & Annuity Company	301503	Agent - Variable Life and Variable Annuities	6/15/2007	3/31/2010
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	12/4/2023
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/28/2018	12/19/2019
Active	Humana Insurance Company	301104	Agent - Health	12/4/2023
Inactive	Humana Insurance Company	301104	Agent - Life	9/25/2018	4/8/2020
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	7/10/2007	3/31/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	7/10/2007	3/31/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Health	7/10/2007	3/31/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Life	7/10/2007	3/31/2010
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	10/29/2002	3/30/2006
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	10/31/2002	11/1/2004
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	10/31/2002	11/1/2004
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Variable Life and Variable Annuities	10/31/2002	11/1/2004
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	10/31/2002	11/1/2004
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	10/31/2002	11/1/2004
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Variable Life and Variable Annuities	10/31/2002	11/1/2004
Inactive	John Alden Life Insurance Company	300573	Agent - Health	7/10/2000	3/31/2006
Inactive	John Alden Life Insurance Company	300573	Agent - Life	7/10/2000	3/31/2006
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	10/20/1993	3/31/2006
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	8/21/2013	4/26/2016
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Variable Life and Variable Annuities	1/11/2008	3/31/2010
Inactive	Minnesota Life Insurance Company	300488	Agent - Health	11/26/2008	3/31/2010
Inactive	Minnesota Life Insurance Company	300488	Agent - Life	11/26/2008	3/31/2010
Inactive	Minnesota Life Insurance Company	300488	Agent - Variable Life and Variable Annuities	11/26/2008	3/31/2010
Inactive	Pacific Life Insurance Company	301848	Agent - Life	1/22/2008	4/21/2010
Inactive	Pacific Life Insurance Company	301848	Agent - Variable Life and Variable Annuities	1/22/2008	4/21/2010
Inactive	Physicians Life Insurance Company	300924	Agent - Life	10/11/2002	3/31/2006
Inactive	Pruco Life Insurance Company	300954	Agent - Health	6/15/2007	3/31/2010
Inactive	Pruco Life Insurance Company	300954	Agent - Life	6/15/2007	3/31/2010
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Health	7/7/1994	1/27/2003
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Life	7/7/1994	1/27/2003
Active	SilverScript Insurance Company	663526	Agent - Health	3/30/2020
Inactive	State Life Insurance Company	301497	Agent - Health	1/1/2005	3/31/2006
Inactive	State Life Insurance Company	301497	Agent - Life	1/1/2005	3/31/2006
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	1/23/2008	3/31/2010
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	1/23/2008	3/31/2010
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Variable Life and Variable Annuities	1/23/2008	3/31/2010
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	1/23/2008	3/31/2010
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	1/23/2008	3/31/2010
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Variable Life and Variable Annuities	1/23/2008	3/31/2010
Inactive	Time Insurance Company	300683	Agent - Health	1/22/2001	11/18/2002
Inactive	Time Insurance Company	300683	Agent - Life	1/22/2001	11/18/2002
Inactive	Union Central Life Insurance Company	300307	Agent - Health	12/12/2007	3/31/2010
Inactive	Union Central Life Insurance Company	300307	Agent - Life	12/12/2007	3/31/2010
Inactive	Union Central Life Insurance Company	300307	Agent - Variable Life and Variable Annuities	1/18/2008	3/31/2010
Inactive	West Coast Life Insurance Company	301607	Agent - Health	1/4/2010	3/31/2010
Inactive	West Coast Life Insurance Company	301607	Agent - Life	1/4/2010	3/31/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Tri-State Ins Agency Inc	400047	Agent - Life	3/26/2022
Active	Tri-State Ins Agency Inc	400047	Agent - Health	3/30/2020