DEPARTMENT OF INSURANCE

Affiliations

Name	Player's Health Cover Usa Inc.	DOIID	1050159	NAIC NPN	18885342

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	8/5/2019	3/31/2025
Active	Non Resident	Agent	Property	8/5/2019	3/31/2025
Active	Non Resident	Agent	Casualty	8/5/2019	3/31/2025
Denied	Non Resident	Agent	Life
Active	Non Resident	Surplus Lines Broker	Not Applicable	2/8/2020	3/31/2025
* 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
Surplus Lines Broker	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	All Savers Insurance Company	301940	Agent - Health	5/6/2024
Active	AmTrust Insurance Company	300179	Agent - Casualty	9/18/2023
Active	AmTrust Insurance Company	300179	Agent - Property	9/18/2023
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/19/2024
Inactive	Great American Alliance Insurance Company	301247	Agent - Casualty	3/20/2020	3/15/2022
Inactive	Great American Alliance Insurance Company	301247	Agent - Property	3/20/2020	3/15/2022
Inactive	Great American Assurance Company	300327	Agent - Casualty	3/20/2020	3/15/2022
Inactive	Great American Assurance Company	300327	Agent - Property	3/20/2020	3/15/2022
Active	Great American Insurance Company	301586	Agent - Casualty	3/10/2020
Active	Great American Insurance Company	301586	Agent - Health	3/10/2020
Active	Great American Insurance Company	301586	Agent - Property	3/10/2020
Inactive	Great American Insurance Company of New York	301897	Agent - Casualty	3/20/2020	3/15/2022
Inactive	Great American Insurance Company of New York	301897	Agent - Property	3/20/2020	3/15/2022
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	9/18/2023
Active	Milford Casualty Insurance Company	301460	Agent - Property	9/18/2023
Active	Mutual of Omaha Insurance Company	301012	Agent - Health	3/30/2022
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	8/19/2019	9/9/2021
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	8/19/2019	9/9/2021
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	8/19/2019	9/9/2021
Active	Next Insurance US Company	1083825	Agent - Casualty	7/13/2022
Active	Next Insurance US Company	1083825	Agent - Property	7/13/2022
Active	Philadelphia Indemnity Insurance Company	301221	Agent - Casualty	11/8/2019
Active	Philadelphia Indemnity Insurance Company	301221	Agent - Property	11/8/2019
Active	Security National Insurance Company	301151	Agent - Casualty	9/18/2023
Active	Security National Insurance Company	301151	Agent - Property	9/18/2023
Active	Sequoia Insurance Company	628046	Agent - Casualty	9/18/2023
Active	Sequoia Insurance Company	628046	Agent - Property	9/18/2023
Active	Technology Insurance Company	613278	Agent - Casualty	9/18/2023
Active	Technology Insurance Company	613278	Agent - Property	9/18/2023
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	5/6/2024
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	5/6/2024
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/6/2024
Active	Wesco Insurance Company	300534	Agent - Casualty	9/18/2023
Active	Wesco Insurance Company	300534	Agent - Property	9/18/2023

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Burks, Tyrre Andre	1049150	Agent - Casualty	8/5/2019
Active	Burks, Tyrre Andre	1049150	Agent - Health	8/5/2019
Inactive	Burks, Tyrre Andre	1049150	Agent - Life	7/24/2022	7/24/2022
Active	Burks, Tyrre Andre	1049150	Agent - Property	8/5/2019
Active	Burks, Tyrre Andre	1049150	Surplus Lines Broker - Not Applicable	2/8/2020
Denied	Hardin, Christopher Brent	1207419	Agent - Casualty
Denied	Hardin, Christopher Brent	1207419	Agent - Health
Denied	Hardin, Christopher Brent	1207419	Agent - Property
Denied	Hill, Ted Johnsen	1207395	Agent - Health
Active	Pullen, Daniel Patrick	667579	Agent - Casualty	8/10/2023
Active	Pullen, Daniel Patrick	667579	Agent - Health	8/10/2023
Active	Pullen, Daniel Patrick	667579	Agent - Property	8/10/2023