DEPARTMENT OF INSURANCE

Affiliations

Name	Keller, Zachary R	DOIID	720724	NAIC NPN	8866313

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	1/7/2010	6/30/2027
Active	Non Resident	Agent	Life	11/8/2013	6/30/2027
Active	Non Resident	Agent	Health	11/8/2013	6/30/2027
Active	Non Resident	Agent	Property	1/7/2010	6/30/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/2/2018	6/30/2027
* 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	04/15/2025	06/30/2025	05/01/2025	05/01/2025	Yes
Surplus Lines Broker	04/15/2025	06/30/2025	05/01/2025	05/01/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AmGUARD Insurance Company	500010	Agent - Casualty	3/6/2020
Active	AmGUARD Insurance Company	500010	Agent - Property	3/6/2020
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	11/7/2014
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	11/7/2014
Active	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	3/26/2020
Active	American Guarantee and Liability Insurance Company	301216	Agent - Property	3/26/2020
Active	American Zurich Insurance Company	300592	Agent - Casualty	3/26/2020
Active	American Zurich Insurance Company	300592	Agent - Property	3/26/2020
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/21/2019
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/24/2021	12/19/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/24/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/21/2019	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/21/2019	4/15/2025
Active	BrickStreet Mutual Insurance Company	709251	Agent - Casualty	9/28/2015
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	4/3/2020
Active	Colonial American Casualty & Surety Company	300769	Agent - Casualty	3/26/2020
Active	Colonial American Casualty & Surety Company	300769	Agent - Property	3/26/2020
Active	Colonial Life and Accident Insurance Company	300846	Agent - Health	2/2/2015
Active	Colonial Life and Accident Insurance Company	300846	Agent - Life	2/2/2015
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/24/2021
Active	Employers Insurance Company of Wausau	301813	Agent - Casualty	1/25/2018
Active	Employers Insurance Company of Wausau	301813	Agent - Property	1/25/2018
Inactive	Encova Life Insurance Company	301818	Agent - Life	12/6/2018	1/1/2024
Active	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	3/26/2020
Active	Fidelity and Deposit Company of Maryland	300976	Agent - Property	3/26/2020
Active	First Liberty Insurance Corporation (The)	301060	Agent - Casualty	1/25/2018
Active	First Liberty Insurance Corporation (The)	301060	Agent - Property	1/25/2018
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	8/8/2010	9/25/2019
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	8/8/2010	9/25/2019
Active	Hartford Underwriters Insurance Company	301064	Agent - Casualty	12/8/2022
Active	Hartford Underwriters Insurance Company	301064	Agent - Property	12/8/2022
Active	LM Insurance Corporation	301061	Agent - Casualty	1/25/2018
Active	LM Insurance Corporation	301061	Agent - Property	1/25/2018
Active	Liberty Insurance Corporation	300444	Agent - Casualty	1/25/2018
Active	Liberty Insurance Corporation	300444	Agent - Property	1/25/2018
Active	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	1/25/2018
Active	Liberty Mutual Fire Insurance Company	301913	Agent - Property	1/25/2018
Active	Milbank Insurance Company	925185	Agent - Casualty	7/7/2022
Active	Milbank Insurance Company	925185	Agent - Property	7/7/2022
Active	Motorists Commercial Mutual Insurance Company	301941	Agent - Casualty	6/13/2019
Active	Motorists Commercial Mutual Insurance Company	301941	Agent - Property	6/13/2019
Active	Motorists Mutual Insurance Company	300963	Agent - Casualty	10/19/2017
Active	Motorists Mutual Insurance Company	300963	Agent - Property	10/19/2017
Active	NorGUARD Insurance Company	500015	Agent - Casualty	3/6/2020
Active	NorthStone Insurance Company	818905	Agent - Casualty	9/28/2015
Active	Ohio Security Insurance Company	300622	Agent - Casualty	12/8/2021
Active	Ohio Security Insurance Company	300622	Agent - Property	12/8/2021
Active	Pan-American Life Insurance Company	301530	Agent - Life	1/1/2024
Active	PinnaclePoint Insurance Company	819085	Agent - Casualty	9/28/2015
Active	Plaza Insurance Company	300748	Agent - Casualty	4/25/2022
Active	Plaza Insurance Company	300748	Agent - Property	4/25/2022
Inactive	Principal Life Insurance Company	300129	Agent - Health	8/2/2018	11/22/2022
Inactive	Principal Life Insurance Company	300129	Agent - Life	8/2/2018	11/22/2022
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - Casualty	3/6/2020	12/16/2021
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - Property	3/6/2020	12/16/2021
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	3/14/2017	4/8/2019
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	3/14/2017	4/8/2019
Active	SummitPoint Insurance Company	819084	Agent - Casualty	9/28/2015
Active	The Phoenix Insurance Company	301502	Agent - Casualty	11/18/2021
Active	The Phoenix Insurance Company	301502	Agent - Property	11/18/2021
Active	Travelers Casualty and Surety Company of America	301334	Agent - Casualty	3/22/2018
Active	Travelers Casualty and Surety Company of America	301334	Agent - Property	3/22/2018
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	3/16/2017	9/25/2019
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	3/16/2017	9/25/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/17/2014	12/2/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	6/17/2014	12/2/2016
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	6/17/2014	12/2/2016
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	6/17/2014	12/2/2016
Active	Zurich American Insurance Company	301121	Agent - Casualty	3/26/2020
Active	Zurich American Insurance Company	301121	Agent - Property	3/26/2020
Active	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	3/26/2020
Active	Zurich American Insurance Company of Illinois	301805	Agent - Property	3/26/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Assuredpartners Of West Virginia, LLC	795985	Surplus Lines Broker - Not Applicable	10/31/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Life	1/22/2019	2/10/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Health	1/22/2019	2/10/2025
Inactive	Medlink Inc	400721	Agent - Life	1/15/2019	3/31/2024
Inactive	Medlink Inc	400721	Agent - Health	1/15/2019	3/31/2024