DEPARTMENT OF INSURANCE

Affiliations

Name	Kelsey, Mark R	DOIID	368341	NAIC NPN	230628

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	6/1/1994	6/30/2027
Active	Non Resident	Agent	Life	12/6/2002	6/30/2027
Active	Non Resident	Agent	Health	12/6/2002	6/30/2027
* 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
Administrator	04/15/2025	06/30/2025	05/20/2025	05/20/2025	Yes
Agent	04/15/2025	06/30/2025	05/20/2025	05/20/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc.	300694	Agent - Health	10/11/2006	12/31/2007
Active	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/6/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	10/11/2006
Active	Aetna Life Insurance Company	301140	Agent - Life	10/11/2006
Inactive	American General Assurance Company	300586	Agent - Health	8/14/2009	7/25/2011
Inactive	American General Assurance Company	300586	Agent - Life	8/14/2009	7/25/2011
Active	American General Life Insurance Company	301585	Agent - Health	11/1/2015
Active	American General Life Insurance Company	301585	Agent - Life	11/1/2015
Active	American National Life Insurance Company of Texas	300912	Agent - Health	1/22/2008
Active	American National Life Insurance Company of Texas	300912	Agent - Life	1/22/2008
Active	Ameritas Life Insurance Corporation	300126	Agent - Health	12/31/2016
Active	Ameritas Life Insurance Corporation	300126	Agent - Life	12/31/2016
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	4/14/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/1/2005	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/1/2005	4/15/2025
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	4/28/2008	7/28/2010
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	11/19/2014
Active	CIGNA Health & Life Insurance Company	301783	Agent - Life	11/19/2014
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022	5/26/2025
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/28/2009	3/14/2019
Inactive	CompBenefits Insurance Company	301864	Agent - Life	2/20/2006	7/2/2013
Active	Companion Life Insurance Company	300191	Agent - Health	5/23/2023
Active	Companion Life Insurance Company	300191	Agent - Life	5/23/2023
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	12/23/2008	6/11/2014
Active	Coventry Health and Life Insurance Company	301771	Agent - Health	4/30/2014
Active	Coventry Health and Life Insurance Company	301771	Agent - Life	4/30/2014
Active	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009
Active	First Health Life & Health Insurance Company	301735	Agent - Health	12/16/2010
Active	Guardian Life Insurance Company of America	301316	Agent - Health	8/11/2021
Active	Guardian Life Insurance Company of America	301316	Agent - Life	8/11/2021
Inactive	HCC Life Insurance Company	301827	Agent - Health	1/27/2016	6/12/2017
Inactive	Hartford Life Group Insurance Company	301708	Agent - Health	9/26/2005	12/31/2006
Inactive	Hartford Life Group Insurance Company	301708	Agent - Life	9/26/2005	12/31/2006
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	11/21/2011
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	11/21/2011
Active	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	1/5/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	1/5/2015	2/23/2018
Active	Humana Health Plan, Inc.	300142	Agent - Health	10/26/2006
Active	Humana Insurance Company	301104	Agent - Health	10/26/2006
Active	Humana Insurance Company	301104	Agent - Life	10/26/2006
Active	Humana Insurance Company of Kentucky	300826	Agent - Health	10/26/2006
Active	Humana Insurance Company of Kentucky	300826	Agent - Life	10/26/2006
Active	Humana Medical Plan, Inc.	801568	Agent - Health	1/5/2015
Inactive	HumanaDental Insurance Company	301457	Agent - Health	9/18/2007	5/13/2013
Inactive	HumanaDental Insurance Company	301457	Agent - Life	9/18/2007	5/13/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/22/2012	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/22/2012	10/22/2015
Active	Metropolitan Life Insurance Company	301948	Agent - Health	10/28/2019
Active	Metropolitan Life Insurance Company	301948	Agent - Life	10/28/2019
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	9/25/2007	12/26/2012
Active	National Health Insurance Company	300554	Agent - Health	5/31/2024
Active	National Health Insurance Company	300554	Agent - Life	5/31/2024
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	1/25/2010	11/5/2011
Active	Renaissance Life & Health Insurance Company of America	301447	Agent - Health	4/11/2014
Inactive	Revol One Insurance Company	300681	Agent - Life	10/6/2011	5/31/2012
Inactive	Security Life Insurance Company of America	300936	Agent - Health	8/12/2008	12/31/2016
Inactive	Security Life Insurance Company of America	300936	Agent - Life	8/12/2008	12/31/2016
Active	SilverScript Insurance Company	663526	Agent - Health	1/28/2009
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	2/8/2007	3/5/2010
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	2/8/2007	3/5/2010
Inactive	Starmount Life Insurance Company	628031	Agent - Health	1/1/2015	10/8/2021
Inactive	Starmount Life Insurance Company	628031	Agent - Life	1/1/2015	10/8/2021
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	4/24/2013	10/1/2015
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	4/24/2013	10/1/2015
Inactive	Symetra Life Insurance Company	301691	Agent - Health	9/19/2005	9/11/2014
Inactive	Symetra Life Insurance Company	301691	Agent - Life	9/19/2005	9/11/2014
Inactive	Time Insurance Company	300683	Agent - Health	8/22/2012	11/22/2019
Inactive	Time Insurance Company	300683	Agent - Life	8/22/2012	11/22/2019
Active	Transamerica Life Insurance Company	300571	Agent - Health	8/19/2015
Active	Transamerica Life Insurance Company	300571	Agent - Life	8/19/2015
Active	Unimerica Insurance Company	563724	Agent - Health	3/21/2008
Active	Unimerica Insurance Company	563724	Agent - Life	3/21/2008
Inactive	United American Insurance Company	300910	Agent - Health	10/27/2006	12/28/2006
Inactive	United American Insurance Company	300910	Agent - Life	10/27/2006	12/28/2006
Active	United States Life Insurance Company in the City of New York	301126	Agent - Health	11/1/2015
Active	United States Life Insurance Company in the City of New York	301126	Agent - Life	11/1/2015
Inactive	United World Life Insurance Company	300532	Agent - Health	9/25/2007	12/8/2011
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	12/18/2019	5/26/2025
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	3/21/2008
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/16/2016	12/20/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	12/18/2019	12/22/2022
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	12/18/2019	12/23/2021
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	3/21/2008	11/30/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	12/18/2019	5/26/2025
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	12/20/2019	12/29/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	3/7/2019	12/29/2021
Active	Wellpoint Life and Health Insurance Company	300469	Agent - Health	11/17/2006
Active	Wellpoint Life and Health Insurance Company	300469	Agent - Life	11/17/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dental Choice Agency Inc.	398085	Agent - Health	1/29/2021
Active	Designated Agent Company Inc.	681257	Agent - Health	12/17/2013
Active	Designated Agent Company Inc.	681257	Agent - Life	12/17/2013
Active	Kelsey National Corporation	398031	Administrator - Not Applicable	6/1/1994
Active	Kelsey National Corporation	398031	Agent - Health	2/18/2005
Active	Kelsey National Corporation	398031	Agent - Life	2/18/2005
Inactive	Medlink Inc	400721	Agent - Health	9/16/2005	3/31/2024
Inactive	Medlink Inc	400721	Agent - Life	9/16/2005	3/31/2024