DEPARTMENT OF INSURANCE

Affiliations

Name	Ellis, Kiley Ann	DOIID	641586	NAIC NPN	7078163

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	7/6/2021	11/30/2026
Active	Non Resident	Agent	Life	7/6/2021	11/30/2026
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	7/25/2014	11/30/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Health	7/25/2014	11/30/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Life	7/25/2014	11/30/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/24/2015	3/29/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/24/2015	3/29/2016
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	6/24/2015	3/29/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/24/2015	3/29/2016
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	6/22/2015	11/30/2016
Inactive	HCC Life Insurance Company	301827	Agent - Health	7/6/2015	10/3/2016
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	6/24/2015	3/29/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	6/24/2015	3/29/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	6/24/2015	3/29/2016
Inactive	Humana Insurance Company	301104	Agent - Health	6/24/2015	3/29/2016
Inactive	Humana Insurance Company	301104	Agent - Life	6/24/2015	3/29/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	6/24/2015	3/29/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	6/24/2015	3/29/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	6/24/2015	3/29/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	6/24/2015	11/3/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	6/24/2015	11/3/2015
Inactive	Time Insurance Company	300683	Agent - Health	11/2/2012	7/15/2015
Inactive	Time Insurance Company	300683	Agent - Life	11/2/2012	7/15/2015
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/13/2015	1/5/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	7/13/2015	1/5/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/13/2015	1/5/2016
Active	Vision Service Plan Insurance Company	300526	Agent - Health	12/1/2022

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	6/24/2015	3/29/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/24/2015	3/29/2016
Inactive	Healthcompare Ins Services Inc	708319	Agent - Health	7/27/2015	4/12/2016
Inactive	Healthcompare Ins Services Inc	708319	Agent - Life	7/27/2015	4/12/2016