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	6/30/2025
Active	Non Resident	Agent	Health	12/6/2002	6/30/2025
Active	Non Resident	Agent	Life	12/6/2002	6/30/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

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 Life Insurance Company	301209	Agent - Health	9/1/2005
Active	Anthem Life Insurance Company	301209	Agent - Life	9/1/2005
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
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
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
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	12/18/2019
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
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	12/18/2019
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