DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Grant, Kishma	DOIID	975579	NAIC NPN	17906999

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	11/4/2017		3/31/2027
Active	Non Resident	Agent	Health	11/4/2017		3/31/2027
* 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	01/15/2025	03/31/2025	02/26/2025	02/26/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CMFG Life Insurance Company	300929	Agent - Health	7/10/2019	7/12/2022
Inactive	CMFG Life Insurance Company	300929	Agent - Life	7/10/2019	7/12/2022
Active	Combined Insurance Company of America	301472	Agent - Health	6/17/2024
Active	Combined Insurance Company of America	301472	Agent - Life	6/17/2024
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	6/11/2019	12/29/2020
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	6/11/2019	12/29/2020
Inactive	MEMBERS Life Insurance Company	301289	Agent - Life	9/22/2021	7/12/2022
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	11/6/2024
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	11/6/2024
Active	ReliaStar Life Insurance Company	301712	Agent - Health	2/10/2022
Active	ReliaStar Life Insurance Company	301712	Agent - Life	2/10/2022
Active	Starmount Life Insurance Company	628031	Agent - Health	11/6/2024
Active	Trustmark Insurance Company	300317	Agent - Health	3/24/2024
Active	Trustmark Insurance Company	300317	Agent - Life	3/24/2024
Active	UNUM Life Insurance Company of America	300817	Agent - Health	11/6/2024
Active	UNUM Life Insurance Company of America	300817	Agent - Life	11/6/2024
Active	Unum Insurance Company	301499	Agent - Health	11/6/2024
Active	Unum Insurance Company	301499	Agent - Life	11/6/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Of Illinois Inc	398318	Agent - Life	11/4/2019	1/7/2020
Inactive	Willis Of Illinois Inc	398318	Agent - Health	11/4/2019	1/7/2020
Active	Willis Towers Watson Midwest, Inc	534348	Agent - Life	2/6/2020
Active	Willis Towers Watson Midwest, Inc	534348	Agent - Health	2/6/2020