DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Lisa, Michael T	DOIID	696054	NAIC NPN	3290840

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	12/22/2008		3/31/2026
Active	Non Resident	Agent	Life	12/22/2008		3/31/2026
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	9/9/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/9/2024
Active	Arch Insurance Company	300688	Agent - Health	1/21/2020
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	3/9/2023	4/7/2023
Active	Colonial Life and Accident Insurance Company	300846	Agent - Health	3/18/2014
Active	Colonial Life and Accident Insurance Company	300846	Agent - Life	3/18/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/9/2012	5/1/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/9/2012	5/1/2014
Inactive	Humana Insurance Company	301104	Agent - Health	8/8/2012	5/1/2014
Inactive	Humana Insurance Company	301104	Agent - Life	8/8/2012	5/1/2014
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/9/2012	5/1/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/9/2012	5/1/2014
Inactive	Sierra Health and Life Insurance Company Inc.	300357	Agent - Health	3/9/2023	4/7/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/9/2023	4/7/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	3/2/2011	12/1/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/2/2011	12/1/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	3/2/2011	12/1/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	3/9/2023	4/7/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Corporate Synergies Group LLC	618292	Agent - Life	4/4/2011
Active	Corporate Synergies Group LLC	618292	Agent - Health	4/4/2011
Active	Frp Insurance Services, LLC	1313627	Agent - Life	10/31/2024
Active	Frp Insurance Services, LLC	1313627	Agent - Health	10/31/2024