DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Tyler, Kelly Ann	DOIID	619005	NAIC NPN	8634621

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Adjuster	Independent	10/17/2006	12/10/2008
Inactive	Non Resident	Agent	Life	9/12/2018	9/30/2022
Inactive	Non Resident	Agent	Health	9/12/2018	9/30/2022
Inactive	Resident	Apprentice Adjuster	Not Applicable	10/27/2005	10/17/2006
* 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
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/11/2018	9/30/2022
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/7/2018	1/25/2020
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	10/7/2018	12/21/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/6/2019	1/25/2020
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/7/2018	1/25/2020
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/7/2018	1/25/2020

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	10/11/2018	9/30/2022

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nethery, John T	357757	Apprentice Adjuster - Not Applicable	10/27/2005	10/17/2006