DEPARTMENT OF INSURANCE

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	Life	7/18/2003		7/31/2025
Active	Non Resident	Agent	Health	7/18/2003		7/31/2025
* 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	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
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