DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Boushall, Forrest	DOIID	638250	NAIC NPN	479643

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	8/18/2006		8/31/2025
Active	Non Resident	Agent	Property	8/18/2006		8/31/2025
Active	Non Resident	Agent	Casualty	8/18/2006		8/31/2025
Active	Non Resident	Agent	Health	8/18/2006		8/31/2025
* 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
Agent	06/15/2025	08/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Health	12/20/2007	12/9/2010
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	12/20/2007	12/9/2010
Inactive	Genworth Life Insurance Company	300623	Agent - Health	12/27/2007	12/7/2012
Inactive	Genworth Life Insurance Company	300623	Agent - Life	12/27/2007	12/7/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	1/21/2014	5/2/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	1/11/2011	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	1/11/2011	12/5/2014
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	2/2/2009	12/14/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	2/2/2009	12/14/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending	Marsh & Mclennan Agency LLC	716460	Agent - Health
Pending	Marsh & Mclennan Agency LLC	716460	Agent - Life
Pending	Marsh & Mclennan Agency LLC	716460	Agent - Property
Pending	Marsh & Mclennan Agency LLC	716460	Agent - Casualty
Denied	Mcgriff Insurance Services, LLC	400877	Agent - Health
Denied	Mcgriff Insurance Services, LLC	400877	Agent - Life
Denied	Mcgriff Insurance Services, LLC	400877	Agent - Property
Denied	Mcgriff Insurance Services, LLC	400877	Agent - Casualty
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	1/26/2007	3/2/2007
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	1/26/2007	3/2/2007