DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ehrsam, Michelle	DOIID	1002348	NAIC NPN	18851274

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	7/25/2018	12/9/2021
Inactive	Non Resident	Agent	Life	7/25/2018	12/9/2021
* 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
Inactive	Continental American Insurance Company	301700	Agent - Health	8/8/2018	11/2/2021
Inactive	Continental American Insurance Company	301700	Agent - Life	8/8/2018	11/2/2021
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	8/6/2018	10/8/2021
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	8/6/2018	10/8/2021
Inactive	Starmount Life Insurance Company	628031	Agent - Health	8/6/2018	10/8/2021
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	8/6/2018	10/8/2021
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	8/6/2018	10/8/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mercer Health & Benefits Administration Llc	656414	Agent - Health	2/1/2019	11/2/2021
Inactive	Mercer Health & Benefits Administration Llc	656414	Agent - Life	2/1/2019	11/2/2021