DEPARTMENT OF INSURANCE

Affiliations

Name	Kelly, David Eugene	DOIID	603974	NAIC NPN	2061126

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	12/31/2008	9/30/2025
Active	Non Resident	Agent	Casualty	4/9/2007	9/30/2025
Active	Non Resident	Agent	Health	3/28/2005	9/30/2025
Active	Non Resident	Agent	Property	4/9/2007	9/30/2025
Active	Non Resident	Agent	Life	3/28/2005	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
Administrator	07/15/2025	09/30/2025
Agent	07/15/2025	09/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anthem Life Insurance Company	301209	Agent - Health	4/15/2011	5/9/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	4/15/2011	5/18/2017
Active	Colonial Life and Accident Insurance Company	300846	Agent - Health	3/22/2017
Active	Colonial Life and Accident Insurance Company	300846	Agent - Life	3/22/2017
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/13/2013	3/14/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	1/12/2009	12/19/2019
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	5/23/2013
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	5/23/2013
Active	Golden Rule Insurance Company	301943	Agent - Health	5/3/2010
Active	Golden Rule Insurance Company	301943	Agent - Life	5/3/2010
Inactive	HM Life Insurance Company	301408	Agent - Health	1/31/2019	9/30/2021
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	4/12/2007	11/5/2008
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	4/12/2007	11/5/2008
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	4/12/2007	12/16/2010
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	4/12/2007	12/16/2010
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	4/12/2007	11/5/2008
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	4/12/2007	11/5/2008
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	4/12/2007	11/5/2008
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	4/12/2007	11/5/2008
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	5/19/2014
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	5/19/2014
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	4/12/2007	11/5/2008
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	4/12/2007	11/5/2008
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/28/2008	12/19/2019
Inactive	Humana Insurance Company	301104	Agent - Health	1/28/2008	12/19/2019
Inactive	Humana Insurance Company	301104	Agent - Life	1/28/2008	12/19/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	1/9/2009	12/19/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	1/9/2009	12/19/2019
Inactive	HumanaDental Insurance Company	301457	Agent - Health	1/9/2009	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	1/9/2009	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/26/2011	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/26/2011	10/22/2015
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	7/28/2010	12/4/2020
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Life	7/28/2010	12/4/2020
Active	Mutual of Omaha Insurance Company	301012	Agent - Health	2/10/2011
Active	National Guardian Life Insurance Company	300596	Agent - Health	3/26/2021
Active	Nationwide Life Insurance Company	300495	Agent - Health	3/29/2021
Active	Nationwide Life Insurance Company	300495	Agent - Life	3/29/2021
Inactive	Omaha Insurance Company	751908	Agent - Health	7/13/2012	8/8/2018
Active	Pan-American Life Insurance Company	301530	Agent - Health	10/25/2021
Active	Pan-American Life Insurance Company	301530	Agent - Life	10/25/2021
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/5/2017	7/17/2020
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/5/2017	7/17/2020
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	4/12/2007	11/5/2008
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	4/12/2007	11/5/2008
Active	Standard Life and Accident Insurance Company	301534	Agent - Health	2/22/2012
Inactive	Time Insurance Company	300683	Agent - Health	7/30/2014	11/23/2019
Inactive	Time Insurance Company	300683	Agent - Life	7/30/2014	11/23/2019
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	10/28/2005	11/8/2010
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	10/28/2005	11/8/2010
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	10/28/2005	10/1/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	10/28/2005	10/1/2008
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	4/12/2007	11/5/2008
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	4/12/2007	11/5/2008
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	10/5/2017	7/17/2020
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	10/5/2017	7/17/2020
Active	United of Omaha Life Insurance Company	300156	Agent - Health	2/10/2011
Active	United of Omaha Life Insurance Company	300156	Agent - Life	2/10/2011
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/12/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/12/2015	11/4/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	4/15/2011	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	4/15/2011	11/2/2016
Active	Kelly & Associates Ins Group Inc.	616214	Agent - Health	12/8/2009
Active	Kelly & Associates Ins Group Inc.	616214	Agent - Life	4/24/2009
Active	Kelly & Associates Ins Group Inc.	616214	Administrator - Not Applicable	12/31/2008
Active	Kelly Integrated Workers Compensation Strategies, Inc.	652408	Agent - Casualty	4/18/2007
Active	Kelly Integrated Workers Compensation Strategies, Inc.	652408	Agent - Property	4/18/2007