DEPARTMENT OF INSURANCE

Affiliations

Name	Tri-State Ins Agency Inc	DOIID	400047	NAIC NPN	2110447

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	6/28/2012		3/31/2026
Active	Resident	Agent	Life	6/28/2012		3/31/2026
Inactive	Resident	Agent	General Lines	9/9/1991	8/15/2000
Inactive	Resident	Agent	Property	8/15/2000	4/22/2002
Inactive	Resident	Agent	Casualty	8/15/2000	4/22/2002
* 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
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	5/31/2001	12/5/2006
Inactive	American General Life Insurance Company	301585	Agent - Health	2/14/2008	3/31/2012
Inactive	American General Life Insurance Company	301585	Agent - Life	2/14/2008	3/31/2012
Inactive	American National Insurance Company	301861	Agent - Health	6/3/2015	6/14/2021
Active	American National Insurance Company	301861	Agent - Life	6/3/2015
Inactive	American Pioneer Life Insurance Company	301782	Agent - Health	7/22/1998	3/31/1999
Inactive	American Pioneer Life Insurance Company	301782	Agent - Life	7/22/1998	3/31/1999
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	7/14/2012
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	7/14/2012	10/16/2012
Inactive	Anthem Life Insurance Company	301209	Agent - Health	7/14/2012	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/14/2012	4/15/2025
Inactive	Bankers United Life Assurance Company	300296	Agent - Health	7/20/1995	5/17/1996
Inactive	Bankers United Life Assurance Company	300296	Agent - Life	7/20/1995	5/17/1996
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Health	12/20/1995	3/31/1997
Inactive	Centennial Life Insurance Company (The)	301561	Agent - Life	12/20/1995	3/31/1997
Inactive	Conseco Health Insurance Company	301725	Agent - Health	4/25/2001	10/1/2010
Inactive	Conseco Health Insurance Company	301725	Agent - Life	5/31/2001	10/1/2010
Inactive	Conseco Insurance Company	301202	Agent - Health	11/30/2004	10/1/2010
Inactive	Conseco Insurance Company	301202	Agent - Life	11/30/2004	10/1/2010
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	12/30/1997	12/16/2008
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	5/31/2001	12/16/2008
Inactive	Freedom Life Insurance Company of America	300074	Agent - Health	3/31/1994	3/31/1997
Inactive	Freedom Life Insurance Company of America	300074	Agent - Life	3/31/1994	3/31/1997
Inactive	Generali - U.S. Branch	301128	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Generali - U.S. Branch	301128	Agent - General Lines	9/9/1991	8/15/2000
Inactive	Generali - U.S. Branch	301128	Agent - Property	8/15/2000	3/31/2002
Inactive	Golden Rule Insurance Company	301943	Agent - Health	10/8/1986	3/31/2012
Inactive	Golden Rule Insurance Company	301943	Agent - Life	5/31/2001	3/31/2012
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Health	10/8/1986	3/31/2012
Inactive	Investors Heritage Life Insurance Company	300363	Agent - Life	5/31/2001	3/31/2012
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	12/11/2012	6/2/2014
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	11/6/2002	12/30/2009
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	11/6/2002	12/30/2009
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	9/19/2008	3/31/2012
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	9/19/2008	3/31/2012
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Health	12/1/1998	12/31/2003
Inactive	Kentucky Home Life Insurance Company	300477	Agent - Life	12/1/1998	12/31/2003
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	12/5/2012	7/14/2014
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	12/5/2012	7/14/2014
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	4/9/1997	5/15/2006
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Health	8/19/1982	2/26/2001
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Life	8/19/1982	2/26/2001
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	8/25/2003	4/12/2004
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	8/25/2003	4/12/2004
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	11/27/2008	6/24/2011
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	11/27/2008	3/31/2012
Inactive	Principal Life Insurance Company	300129	Agent - Health	12/4/1997	11/30/2003
Inactive	Principal Life Insurance Company	300129	Agent - Life	12/4/1997	11/30/2003
Inactive	Progressive Max Insurance Company	301034	Agent - Casualty	8/15/2000	4/22/2002
Inactive	Progressive Max Insurance Company	301034	Agent - General Lines	8/30/1999	8/15/2000
Inactive	Progressive Max Insurance Company	301034	Agent - Property	8/15/2000	4/22/2002
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	8/15/2000	4/22/2002
Inactive	Progressive Northern Insurance Company	301378	Agent - General Lines	8/30/1999	8/15/2000
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	8/15/2000	4/22/2002
Inactive	Progressive Northwestern Insurance Company	300441	Agent - Casualty	8/15/2000	4/22/2002
Inactive	Progressive Northwestern Insurance Company	300441	Agent - General Lines	8/30/1999	8/15/2000
Inactive	Progressive Northwestern Insurance Company	300441	Agent - Property	8/15/2000	4/22/2002
Inactive	QBE Insurance Corporation	300515	Agent - General Lines	12/8/1999	6/29/2000
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Health	4/26/1994	7/18/2003
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Life	4/26/1994	7/18/2003
Inactive	South Carolina Insurance Company	300080	Agent - Casualty	8/15/2000	4/22/2002
Inactive	South Carolina Insurance Company	300080	Agent - General Lines	5/6/1998	8/15/2000
Inactive	South Carolina Insurance Company	300080	Agent - Property	8/15/2000	4/22/2002
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	10/5/1989	3/31/2012
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Life	5/31/2001	3/31/2012
Inactive	Sterling Investors Life Insurance Company	301785	Agent - Health	8/24/2005	3/31/2012
Inactive	Sterling Investors Life Insurance Company	301785	Agent - Life	8/24/2005	3/31/2012
Inactive	Time Insurance Company	300683	Agent - Health	1/25/2001	11/21/2002
Inactive	Time Insurance Company	300683	Agent - Life	1/25/2001	11/21/2002
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Health	3/20/1996	10/22/2003
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	3/20/1996	10/22/2003
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/27/2008	6/24/2011
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	11/27/2008	3/31/2012
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	1/7/2005	12/20/2006
Inactive	Washington National Insurance Company	300587	Agent - Health	10/1/2010	12/28/2010
Inactive	Washington National Insurance Company	300587	Agent - Life	10/1/2010	12/28/2010

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Western Kentucky Inc.	401302	Agent - Health	7/18/1996	12/31/2001
Inactive	Acordia of Western Kentucky Inc.	401302	Agent - Life	7/18/1996	12/31/2001
Inactive	Alexander, T J	343539	Agent - General Lines	8/19/1982	8/15/2000
Inactive	Alexander, T J	343539	Agent - Health	6/28/2012	5/16/2022
Inactive	Alexander, T J	343539	Agent - Life	6/28/2012	5/16/2022
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	8/17/1999	12/31/2001
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	8/17/1999	12/31/2001
Inactive	Elliott, Juanita Fawndeze	330770	Agent - Health	5/15/1991	1/31/2010
Inactive	Elliott, Juanita Fawndeze	330770	Agent - Life	5/15/1991	1/31/2010
Inactive	Felts, Jackie Ray	365662	Agent - General Lines	8/19/1982	8/15/2000
Inactive	Felts, Jackie Ray	365662	Agent - Health	7/20/2012	10/31/2015
Inactive	Felts, Jackie Ray	365662	Agent - Life	7/20/2012	10/31/2015
Inactive	Felts, James	393992	Agent - General Lines	8/19/1982	3/31/1998
Inactive	Felts, James	393992	Agent - Health	8/19/1982	3/31/2012
Inactive	Felts, James	393992	Agent - Life	8/19/1982	3/31/2012
Inactive	Felts, Stephon S	382909	Agent - Health	5/15/1991	4/16/1997
Inactive	Felts, Stephon S	382909	Agent - Life	5/15/1991	4/16/1997
Inactive	Hollan, Sara J	304428	Agent - Health	5/15/1991	7/1/2004
Inactive	Hollan, Sara J	304428	Agent - Life	5/15/1991	7/1/2004
Active	Kelley, Timothy Odaniel	362577	Agent - Health	3/30/2020
Active	Kelley, Timothy Odaniel	362577	Agent - Life	3/26/2022
Inactive	Morgan, Grey Van	311491	Agent - General Lines	5/15/1991	7/1/1996
Inactive	Morgan, Grey Van	311491	Agent - Health	3/12/2003	7/1/2006
Inactive	Morgan, Grey Van	311491	Agent - Life	3/12/2003	7/1/2006