DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Lively, Carla Ann	DOIID	777762	NAIC NPN	16586125

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Life	8/31/2017		9/30/2025
Active	Resident	Agent	Limited Line Credit	3/26/2012		9/30/2025
Active	Resident	Agent	Health	9/2/2021		9/30/2025
* 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	07/15/2025	09/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Health and Life Insurance Company	300844	Agent - Health	9/3/2021	1/27/2025
Inactive	American Health and Life Insurance Company	300844	Agent - Life	8/31/2017	1/27/2025
Inactive	American Health and Life Insurance Company	300844	Agent - Limited Line Credit	3/26/2012	1/27/2025
Inactive	Merit Life Insurance Co.	300150	Agent - Life	8/31/2017	12/14/2018
Inactive	Merit Life Insurance Co.	300150	Agent - Limited Line Credit	9/15/2016	12/14/2018
Inactive	Triton Insurance Company	300654	Agent - Limited Line Credit	3/26/2012	1/27/2025
Inactive	Yosemite Insurance Company	301519	Agent - Limited Line Credit	9/15/2016	1/23/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Interstate Agency Inc	610890	Agent - Limited Line Credit	8/10/2018	2/21/2019
Inactive	Interstate Agency Inc	610890	Agent - Life	8/10/2018	2/21/2019
Inactive	Onemain Assurance Services LLC	751094	Agent - Limited Line Credit	7/26/2018	1/27/2025
Inactive	Onemain Assurance Services LLC	751094	Agent - Life	6/19/2018	1/27/2025
Inactive	Onemain Assurance Services LLC	751094	Agent - Health	9/3/2021	1/27/2025