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	Life	12/22/2008		3/31/2026
Active	Non Resident	Agent	Health	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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2026	03/31/2026

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