DEPARTMENT OF INSURANCE

Affiliations

Name	Sullivan Jr., Randall Thomas	DOIID	392222	NAIC NPN	7209730

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	2/2/1995		3/31/2026
Active	Resident	Agent	Health	2/2/1995		3/31/2026
Active	Resident	Agent	Property	8/15/2000		3/31/2026
Active	Resident	Agent	Casualty	8/15/2000		3/31/2026
Inactive	Resident	Agent	Health Maintenance Organization	2/2/1995	3/31/1997
Inactive	Resident	Agent	General Lines	2/2/1995	8/15/2000
* 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
Active	American Modern Home Insurance Company	300791	Agent - Casualty	1/26/2023
Active	American Modern Home Insurance Company	300791	Agent - Property	1/26/2023
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	3/28/2019
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	3/28/2019
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	8/24/2015	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	8/24/2015	11/14/2021
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/20/2023
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	2/2/1995	3/31/1997
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	11/20/2023
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	9/8/2022	12/20/2024
Inactive	Bristol West Insurance Company	301655	Agent - Property	9/8/2022	12/20/2024
Active	Dairyland Insurance Company	301370	Agent - Casualty	1/6/2012
Active	Dairyland Insurance Company	301370	Agent - Property	1/6/2012
Active	FB Insurance Company (The)	301763	Agent - Casualty	8/15/2000
Inactive	FB Insurance Company (The)	301763	Agent - General Lines	2/26/1996	8/15/2000
Active	FB Insurance Company (The)	301763	Agent - Property	8/15/2000
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/8/2022
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/8/2022
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	4/7/2011	11/11/2013
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	4/7/2011	11/11/2013
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/16/2010	4/2/2013
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/16/2010	4/2/2013
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Casualty	8/15/2000
Inactive	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - General Lines	2/2/1995	8/15/2000
Active	Kentucky Farm Bureau Mutual Insurance Company	300570	Agent - Property	8/15/2000
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Health	2/2/1995
Active	Southern Farm Bureau Life Insurance Company	300909	Agent - Life	2/2/1995
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	5/5/2011	6/26/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	5/5/2011	6/26/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/13/2013	2/11/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/13/2013	2/11/2025
Inactive	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - General Lines	3/6/1995	8/15/2000
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Life	3/6/1995
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Health	3/6/1995
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Property	8/15/2000
Active	Kentucky Farm Bureau Insurance Agency LLC	399619	Agent - Casualty	8/15/2000
Inactive	Tom Sullivan Insurance Inc.	399282	Agent - General Lines	3/4/1998	8/15/2000
Active	Tom Sullivan Insurance Inc.	399282	Agent - Life	3/4/1998
Active	Tom Sullivan Insurance Inc.	399282	Agent - Health	3/4/1998
Active	Tom Sullivan Insurance Inc.	399282	Agent - Property	8/15/2000
Active	Tom Sullivan Insurance Inc.	399282	Agent - Casualty	8/15/2000