DEPARTMENT OF INSURANCE
Affiliations
NameKelsey National CorporationDOIID398031NAIC NPN720533
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAdministratorNot Applicable6/1/1994 3/31/2026
ActiveNon ResidentAgentHealth2/18/2005 3/31/2026
ActiveNon ResidentAgentLife2/18/2005 3/31/2026
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAetna Health Inc.300694Agent - Health10/11/200612/31/2007
ActiveAetna Health Inc. (PA)660717Agent - Health12/31/2007 
ActiveAetna Health of Ohio Inc.1065035Agent - Health8/6/2020 
ActiveAetna Life Insurance Company301140Agent - Health10/11/2006 
ActiveAetna Life Insurance Company301140Agent - Life10/11/2006 
InactiveAmerican General Assurance Company300586Agent - Health8/14/20097/25/2011
InactiveAmerican General Assurance Company300586Agent - Life8/14/20097/25/2011
ActiveAmerican General Life Insurance Company301585Agent - Health12/31/2012 
ActiveAmerican General Life Insurance Company301585Agent - Life12/31/2012 
InactiveAmerican General Life Insurance Company of Delaware301057Agent - Health4/27/200912/31/2012
InactiveAmerican General Life Insurance Company of Delaware301057Agent - Life4/27/200912/31/2012
ActiveAmerican National Life Insurance Company of Texas300912Agent - Health8/21/2007 
ActiveAmerican National Life Insurance Company of Texas300912Agent - Life8/21/2007 
ActiveAmeritas Life Insurance Corporation300126Agent - Health10/25/2005 
ActiveAmeritas Life Insurance Corporation300126Agent - Life10/25/2005 
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health9/2/2005 
InactiveAnthem Insurance Companies, Inc.300941Agent - Health9/2/200510/16/2012
ActiveAnthem Life Insurance Company301209Agent - Health9/1/2005 
ActiveAnthem Life Insurance Company301209Agent - Life9/1/2005 
InactiveBerkshire Life Insurance Company of America300983Agent - Health6/13/201910/5/2021
InactiveBerkshire Life Insurance Company of America300983Agent - Life6/13/201910/5/2021
ActiveCIGNA Health & Life Insurance Company301783Agent - Health9/14/2014 
ActiveCIGNA Health & Life Insurance Company301783Agent - Life9/14/2014 
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health7/20/2022 
InactiveCompBenefits Dental, Inc.591692Agent - Health7/7/20053/14/2019
InactiveCompBenefits Insurance Company301864Agent - Health2/24/20107/2/2013
InactiveCompBenefits Insurance Company301864Agent - Life2/24/20107/2/2013
ActiveCompanion Life Insurance Company300191Agent - Health5/23/2023 
ActiveCompanion Life Insurance Company300191Agent - Life5/23/2023 
InactiveConnecticut General Life Insurance Company301333Agent - Health12/26/20086/11/2014
ActiveCoventry Health and Life Insurance Company301771Agent - Health4/30/2014 
ActiveCoventry Health and Life Insurance Company301771Agent - Life4/30/2014 
ActiveDental Concern Inc. (The)301641Agent - Health3/21/2009 
ActiveFirst Health Life & Health Insurance Company301735Agent - Health3/17/2011 
InactiveGolden Rule Insurance Company301943Agent - Health8/4/200611/2/2017
InactiveGolden Rule Insurance Company301943Agent - Life8/4/200611/2/2017
InactiveGuardian Insurance & Annuity Company Inc. (The)301920Agent - Life6/13/201910/5/2021
ActiveGuardian Life Insurance Company of America301316Agent - Health6/13/2019 
ActiveGuardian Life Insurance Company of America301316Agent - Life6/13/2019 
InactiveHCC Life Insurance Company301827Agent - Health1/27/20166/20/2017
InactiveHartford Life Group Insurance Company301708Agent - Health9/26/200512/31/2006
InactiveHartford Life Group Insurance Company301708Agent - Life9/26/200512/31/2006
ActiveHartford Life and Accident Insurance Company300878Agent - Health9/26/2005 
ActiveHartford Life and Accident Insurance Company300878Agent - Life9/26/2005 
ActiveHumana Health Plan, Inc.300142Agent - Health9/18/2007 
ActiveHumana Insurance Company301104Agent - Health9/18/2007 
ActiveHumana Insurance Company301104Agent - Life9/18/2007 
ActiveHumana Insurance Company of Kentucky300826Agent - Health9/18/2007 
ActiveHumana Insurance Company of Kentucky300826Agent - Life9/18/2007 
InactiveHumanaDental Insurance Company301457Agent - Health9/18/20072/23/2012
InactiveHumanaDental Insurance Company301457Agent - Life9/18/20072/23/2012
ActiveMetropolitan Life Insurance Company301948Agent - Health10/28/2019 
ActiveMetropolitan Life Insurance Company301948Agent - Life10/28/2019 
ActiveNational Health Insurance Company300554Agent - Health5/31/2024 
ActiveNational Health Insurance Company300554Agent - Life5/31/2024 
InactivePacifiCare Life and Health Insurance Company301304Agent - Health1/25/20108/25/2011
InactivePennsylvania Life Insurance Company301321Agent - Health6/17/20093/31/2013
InactivePennsylvania Life Insurance Company301321Agent - Life6/17/20093/31/2013
InactiveRevol One Insurance Company300681Agent - Life7/28/201112/28/2012
InactiveSecurity Life Insurance Company of America300936Agent - Health8/12/200812/31/2016
InactiveSecurity Life Insurance Company of America300936Agent - Life8/12/200812/31/2016
ActiveSilverScript Insurance Company663526Agent - Health3/13/2015 
InactiveStandard Security Life Insurance Company of NY301487Agent - Health2/7/20071/20/2010
InactiveStandard Security Life Insurance Company of NY301487Agent - Life2/7/20071/20/2010
InactiveStarmount Life Insurance Company628031Agent - Health3/15/201611/30/2023
InactiveStarmount Life Insurance Company628031Agent - Life3/15/201611/30/2023
InactiveStonebridge Life Insurance Company301614Agent - Health1/31/201210/1/2015
InactiveStonebridge Life Insurance Company301614Agent - Life1/31/201210/1/2015
InactiveSymetra Life Insurance Company301691Agent - Health9/19/20059/12/2014
InactiveSymetra Life Insurance Company301691Agent - Life9/19/20059/12/2014
InactiveTime Insurance Company300683Agent - Health4/1/201411/15/2019
InactiveTime Insurance Company300683Agent - Life4/1/201411/15/2019
ActiveTransamerica Life Insurance Company300571Agent - Health8/20/2015 
ActiveTransamerica Life Insurance Company300571Agent - Life8/20/2015 
InactiveUnited American Insurance Company300910Agent - Health10/27/200612/28/2006
InactiveUnited American Insurance Company300910Agent - Life10/27/200612/28/2006
ActiveUnited States Life Insurance Company in the City of New York301126Agent - Health7/18/2013 
ActiveUnited States Life Insurance Company in the City of New York301126Agent - Life7/18/2013 
ActiveUnitedHealthcare Insurance Company300946Agent - Health12/18/2019 
InactiveUnitedHealthcare Insurance Company of America301552Agent - Health9/16/201612/20/2018
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health12/18/201912/22/2022
InactiveUnitedHealthcare Life Insurance Company301517Agent - Health11/11/201511/4/2016
InactiveUnitedHealthcare Life Insurance Company301517Agent - Life11/11/201511/4/2016
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health12/18/201912/23/2021
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health8/18/201112/5/2016
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health12/18/2019 
ActiveWellCare Health Insurance Company of Kentucky, Inc.301478Agent - Health4/6/2022 
InactiveWellCare Health Insurance of Arizona, Inc.501692Agent - Health10/28/20084/29/2010
InactiveWellCare Health Insurance of Arizona, Inc.501692Agent - Life10/28/20084/29/2010
ActiveWellCare Prescription Insurance Inc.654329Agent - Health4/6/2022 
ActiveWellpoint Life and Health Insurance Company300469Agent - Health11/14/2006 
ActiveWellpoint Life and Health Insurance Company300469Agent - Life11/14/2006 
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBrown, Samuel Martin 636000Agent - Health6/2/20215/12/2022
InactiveBrown, Samuel Martin 636000Agent - Life6/2/20215/12/2022
ActiveKelsey, Mark R 368341Administrator - Not Applicable6/1/1994 
ActiveKelsey, Mark R 368341Agent - Health2/18/2005 
ActiveKelsey, Mark R 368341Agent - Life2/18/2005 
InactiveKelsey, Van Rensselaer 655670Agent - Health11/27/201312/1/2021
InactiveKelsey, Van Rensselaer 655670Agent - Life11/27/201311/22/2019
DeniedOrtega, Jesus Hector 692204Agent - Health  
DeniedOrtega, Jesus Hector 692204Agent - Life  
DeniedSmith, Avery Akwasi 973627Agent - Health  
InactiveSmith, Avery Akwasi 973627Agent - Life8/16/20182/21/2020

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