DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Crouch, Lisa	DOIID	515474	NAIC NPN	2346450

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/19/2000		12/31/2025
Active	Non Resident	Agent	Life	10/19/2000		12/31/2025
* 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	10/15/2025	12/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Bankers Life Assurance Company of Florida	300171	Agent - Health	10/19/2000	12/9/2002
Inactive	American Bankers Life Assurance Company of Florida	300171	Agent - Life	10/19/2000	12/9/2002
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/28/2015	12/13/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/28/2015	12/13/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/28/2015	12/13/2016
Inactive	Humana Insurance Company	301104	Agent - Health	9/28/2015	12/13/2016
Inactive	Humana Insurance Company	301104	Agent - Life	9/28/2015	12/13/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/28/2015	12/13/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/28/2015	12/13/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/5/2015	4/25/2017
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/5/2015	4/25/2017
Active	Life Insurance Company of North America	300711	Agent - Health	5/4/2007
Active	Life Insurance Company of North America	300711	Agent - Life	5/4/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Sterling Jewelers Insurance Agency Inc	515475	Agent - Life	10/19/2000	12/9/2002
Inactive	Sterling Jewelers Insurance Agency Inc	515475	Agent - Health	10/19/2000	12/9/2002
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	5/10/2007	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	5/10/2007	10/9/2019
Active	Usi Insurance Services LLC	669260	Agent - Life	12/27/2018
Active	Usi Insurance Services LLC	669260	Agent - Health	12/27/2018