DEPARTMENT OF INSURANCE
Affiliations
NameBloss, Michael ThomasDOIID1184252NAIC NPN16493521
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife1/21/2022 10/31/2024
ActiveNon ResidentAgentHealth1/21/2022 10/31/2024
ActiveNon ResidentAgentVariable Life and Variable Annuities1/21/2022 10/31/2024
* 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.

License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent08/15/202410/31/2024   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveFortitude Life Insurance & Annuity Company301503Agent - Life2/28/2022 
ActiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities2/28/2022 
ActivePruco Life Insurance Company300954Agent - Life2/28/2022 
ActivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities2/28/2022 
ActivePrudential Insurance Company of America300784Agent - Health2/28/2022 
ActivePrudential Insurance Company of America300784Agent - Life2/28/2022 
ActivePrudential Insurance Company of America300784Agent - Variable Life and Variable Annuities2/28/2022 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActivePrudential Insurance Agency LLC620187Agent - Life3/1/2022 
ActivePrudential Insurance Agency LLC620187Agent - Health3/1/2022 
ActivePrudential Insurance Agency LLC620187Agent - Variable Life and Variable Annuities3/1/2022 

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