DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Goucher, Mary Ann	DOIID	546465	NAIC NPN	7224659

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	7/2/2002		7/31/2026
Active	Resident	Agent	Life	1/14/2021		7/31/2026
Inactive	Resident	Temporary Agent	Life	7/1/2020	12/28/2020
* 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	05/15/2026	07/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ameritas Life Insurance Corporation	300126	Temporary Agent - Life	7/1/2020	12/28/2020
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health	10/30/2006	3/31/2019
Inactive	Kentucky Health Cooperative, Inc.	798780	Agent - Health	10/11/2013	10/29/2015
Inactive	Midland National Life Insurance Company	300923	Agent - Health	7/2/2002	3/1/2005
Denied	Midland National Life Insurance Company	300923	Agent - Life

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Assuredpartners NL, LLC	762387	Agent - Health	9/26/2011	3/31/2019
Inactive	Neace Lukens, Inc.	398909	Agent - Health	8/2/2010	3/31/2014
Inactive	R. Carr Insurance Agency Inc.	399034	Agent - Health	8/5/2002	3/1/2005