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	Casualty	8/15/2000		3/31/2026
Active	Resident	Agent	Life	2/2/1995		3/31/2026
Active	Resident	Agent	Property	8/15/2000		3/31/2026
Active	Resident	Agent	Health	2/2/1995		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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2026	03/31/2026

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