DEPARTMENT OF INSURANCE

Affiliations

Name	Energy Insurance Brokerage, Inc.	DOIID	1022233	NAIC NPN	18983595

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	8/13/2020	3/31/2026
Active	Non Resident	Agent	Life	8/13/2020	3/31/2026
Active	Non Resident	Agent	Property	8/13/2020	3/31/2026
Active	Non Resident	Agent	Health	8/13/2020	3/31/2026
Denied	Non Resident	Agent	Personal Lines
Denied	Non Resident	Agent	Self-Service Storage Space
Denied	Non Resident	Agent	Variable Life and Variable Annuities
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Blaasch, Annmarie	1022344	Agent - Casualty	12/13/2018	12/6/2019
Inactive	Blaasch, Annmarie	1022344	Agent - Health	12/13/2018	12/6/2019
Inactive	Blaasch, Annmarie	1022344	Agent - Life	12/13/2018	12/6/2019
Inactive	Blaasch, Annmarie	1022344	Agent - Property	12/13/2018	12/6/2019
Active	Kelder, Mark Todd	322658	Agent - Casualty	8/13/2020
Active	Kelder, Mark Todd	322658	Agent - Health	8/13/2020
Active	Kelder, Mark Todd	322658	Agent - Life	8/13/2020
Active	Kelder, Mark Todd	322658	Agent - Property	8/13/2020