DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Wallace, Keith A	DOIID	542866	NAIC NPN	5762178

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	10/4/2023		9/30/2025
Active	Non Resident	Agent	Health	10/4/2023		9/30/2025
Active	Non Resident	Agent	Casualty	10/4/2023		9/30/2025
Active	Non Resident	Agent	Life	10/4/2023		9/30/2025
* 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	07/15/2025	09/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	10/26/2023
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	10/26/2023
Active	Aetna Life Insurance Company	301140	Agent - Health	10/26/2023
Inactive	Dental Choice, Inc.	301702	Agent - Health	12/19/2001	12/31/2003
Active	SilverScript Insurance Company	663526	Agent - Health	10/26/2023
Active	Thrivent Financial for Lutherans	301101	Agent - Health	12/2/2024
Active	Thrivent Financial for Lutherans	301101	Agent - Life	12/2/2024
Denied	Union Labor Life Insurance Company	301832	Agent - Health

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Trucordia Insurance Services, LLC	976137	Agent - Health	5/6/2025
Active	Trucordia Insurance Services, LLC	976137	Agent - Life	5/6/2025
Pending	Trucordia Insurance Services, LLC	976137	Agent - Casualty
Pending	Trucordia Insurance Services, LLC	976137	Agent - Property