DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Larson, Kristen	DOIID	658854	NAIC NPN	2090062

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/5/2007		7/31/2026
Active	Non Resident	Agent	Life	7/5/2007		7/31/2026
* 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
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	7/31/2015
Active	CIGNA Health & Life Insurance Company	301783	Agent - Life	7/31/2015
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	7/23/2008	12/30/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	7/23/2008	12/30/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	7/23/2008	12/30/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	7/23/2008	12/30/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Mercer Health & Benefits LLC	607080	Agent - Health	1/15/2019
Active	Mercer Health & Benefits LLC	607080	Agent - Life	1/15/2019