DEPARTMENT OF INSURANCE
Affiliations
NameForum Benefits, LLCDOIID1115625NAIC NPN13721907
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentCasualty1/6/2021 3/31/2025
ActiveNon ResidentAgentHealth1/6/2021 3/31/2025
ActiveNon ResidentAgentProperty1/6/2021 3/31/2025
ActiveNon ResidentAgentLife1/6/2021 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
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202503/31/2025   
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBerartez, Isabel 1160300Agent - Health6/16/20224/4/2023
InactiveBerartez, Isabel 1160300Agent - Life6/16/20224/4/2023
ActiveFalco, Bernard Joseph 705295Agent - Health7/7/2021 
ActiveFalco, Bernard Joseph 705295Agent - Life7/7/2021 
InactiveHaskins, Pamela Jean 714491Agent - Health6/9/20218/5/2021
InactiveHaskins, Pamela Jean 714491Agent - Life6/9/20218/5/2021
ActiveLevitz, Alan J 312664Agent - Casualty1/6/2021 
ActiveLevitz, Alan J 312664Agent - Health1/6/2021 
ActiveLevitz, Alan J 312664Agent - Life1/6/2021 
ActiveLevitz, Alan J 312664Agent - Property1/6/2021 
InactiveOsborn, Diane R 1111351Agent - Health12/20/20222/15/2023
InactiveOsborn, Diane R 1111351Agent - Life12/20/20222/15/2023
InactivePost, Julia K 698454Agent - Health6/9/20216/23/2023
InactivePost, Julia K 698454Agent - Life6/9/20216/23/2023
DeniedSalas, Giovanni Antonio 1125016Agent - Health  
InactiveVelasquez, Rosa Esmeralda 727792Agent - Health7/7/20218/5/2021
InactiveVelasquez, Rosa Esmeralda 727792Agent - Life7/7/20218/5/2021
InactiveWhitfield, Cheri 1133878Agent - Health10/7/20212/24/2022

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