DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Deroin, Susan	DOIID	1061037	NAIC NPN	19314333

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/15/2019		7/31/2025
Active	Non Resident	Agent	Life	10/15/2019		7/31/2025
* 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
Active	Anthem Life Insurance Company	301209	Agent - Health	11/2/2019
Active	Anthem Life Insurance Company	301209	Agent - Life	11/2/2019
Active	Dental Care Plus Inc.	301495	Agent - Health	4/22/2020
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	4/23/2020
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	4/23/2020
Active	Sun Life Assurance Company of Canada	301811	Agent - Health	2/4/2020
Active	Sun Life Assurance Company of Canada	301811	Agent - Life	2/4/2020
Active	United of Omaha Life Insurance Company	300156	Agent - Health	6/6/2023
Active	United of Omaha Life Insurance Company	300156	Agent - Life	6/6/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Designated Agent Company Inc.	681257	Agent - Life	11/4/2019
Active	Designated Agent Company Inc.	681257	Agent - Health	11/4/2019
Active	Paychex Insurance Agency Inc	509469	Agent - Life	11/2/2019
Active	Paychex Insurance Agency Inc	509469	Agent - Health	11/2/2019