DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Fulks, Jerome B	DOIID	1098317	NAIC NPN	16725272

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	9/15/2020	8/31/2022
Inactive	Non Resident	Agent	Property	8/1/2023	8/31/2024
Inactive	Non Resident	Agent	Casualty	8/1/2023	8/31/2024
* 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	Arcadian Health Plan, Inc.	728196	Agent - Health	11/11/2020	3/9/2021
Inactive	Humana Insurance Company	301104	Agent - Health	10/22/2020	3/9/2021
Inactive	Progressive Direct Insurance Company	301379	Agent - Casualty	8/3/2023	6/17/2024
Inactive	Progressive Direct Insurance Company	301379	Agent - Property	8/3/2023	6/17/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Progressive Advantage Agency , Inc.	518222	Agent - Casualty	8/7/2023	6/17/2024
Inactive	Progressive Advantage Agency , Inc.	518222	Agent - Property	8/7/2023	6/17/2024