DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Myers, Kelly Lee	DOIID	573134	NAIC NPN	5713504

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/18/2003		7/31/2027
Active	Non Resident	Agent	Life	7/18/2003		7/31/2027
* 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	05/15/2025	07/31/2025	06/06/2025	06/06/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	4 Ever Life Insurance Company	301307	Agent - Health	11/3/2017
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	3/28/2006	2/28/2007
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	3/28/2006	2/28/2007
Active	Arch Insurance Company	300688	Agent - Health	10/13/2011
Active	Berkley Life and Health Insurance Company	301421	Agent - Health	3/18/2021
Active	Companion Life Insurance Company	300191	Agent - Health	8/20/2024
Active	Companion Life Insurance Company	300191	Agent - Life	8/20/2024
Inactive	Golden Rule Insurance Company	301943	Agent - Health	9/21/2016	12/13/2016
Inactive	Golden Rule Insurance Company	301943	Agent - Life	9/21/2016	12/14/2016
Active	Guarantee Trust Life Insurance Company	301043	Agent - Health	8/12/2014
Active	Guarantee Trust Life Insurance Company	301043	Agent - Life	8/12/2014
Active	Hartford Fire Insurance Company	300628	Agent - Health	2/27/2019
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	3/18/2019
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	3/18/2019
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	8/25/2003
Active	StarNet Insurance Company	502746	Agent - Health	3/18/2021
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	6/11/2015	8/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	6/11/2015	8/4/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Borden-Perlman Ins Agency Inc	618992	Agent - Health	2/21/2006	2/2/2021
Active	CBIZ Benefits & Ins Services Inc	514101	Agent - Health	8/17/2022
Active	CBIZ Benefits & Ins Services Inc	514101	Agent - Life	8/17/2022