DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Keithley, Michael Donovan	DOIID	825228	NAIC NPN	17085715

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/25/2024		11/30/2027
* 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	8/1/2024
Inactive	CareSource Kentucky Co.	838179	Agent - Health	8/22/2024	12/27/2025
Active	Golden Rule Insurance Company	301943	Agent - Health	9/3/2025
Active	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	8/5/2024
Active	WellCare Health Plans of Kentucky, Inc.	838592	Agent - Health	8/5/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/26/2013	11/30/2017