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	Health	10/4/2023		9/30/2027
Active	Non Resident	Agent	Casualty	10/4/2023		9/30/2027
Active	Non Resident	Agent	Property	10/4/2023		9/30/2027
Active	Non Resident	Agent	Life	10/4/2023		9/30/2027
* 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	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
Active	Banner Life Insurance Company	301696	Agent - Life	11/18/2025
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
Denied	Trucordia Insurance Services, LLC	976137	Agent - Casualty
Denied	Trucordia Insurance Services, LLC	976137	Agent - Property