DEPARTMENT OF INSURANCE

Affiliations

Name	Michelson, Richard M	DOIID	305251	NAIC NPN	3784254

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Adjuster	Independent	7/6/2004	2/19/2007
Active	Resident	Agent	Health	7/31/2006		5/31/2026
Active	Resident	Agent	Casualty	7/31/2006		5/31/2026
Active	Resident	Agent	Life	7/31/2006		5/31/2026
Active	Resident	Agent	Property	7/31/2006		5/31/2026
Inactive	Resident	Agent	General Lines	4/30/1993	8/15/2000
Active	Resident	Property & Casualty Consultant	Not Applicable	10/6/2020		5/31/2026
Active	Resident	Public Adjuster	Property & Casualty	9/8/2010		5/31/2026
Inactive	Resident	Surplus Lines Broker	Not Applicable	5/3/2017	5/31/2020
* 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	AmGUARD Insurance Company	500010	Agent - Casualty	1/23/2019	2/18/2020
Inactive	AmGUARD Insurance Company	500010	Agent - Property	1/23/2019	2/18/2020
Inactive	AmTrust Insurance Company	300179	Agent - Casualty	7/27/2001	3/11/2002
Inactive	AmTrust Insurance Company	300179	Agent - Property	7/27/2001	3/11/2002
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - General Lines	2/3/1997	12/30/1999
Inactive	American Economy Insurance Company	300315	Agent - General Lines	5/10/1994	6/28/2000
Active	American Home Assurance Company	300246	Agent - Casualty	4/13/2007
Active	American Home Assurance Company	300246	Agent - Property	4/13/2007
Inactive	American States Insurance Company	301230	Agent - General Lines	5/10/1994	6/28/2000
Inactive	American States Preferred Insurance Company	300609	Agent - General Lines	5/10/1994	6/28/2000
Inactive	American United Life Insurance Company	300498	Agent - Health	11/29/1990	2/8/1996
Inactive	American United Life Insurance Company	300498	Agent - Life	11/29/1990	2/8/1996
Inactive	Anthem Life Insurance Company	301209	Agent - Health	2/12/1999	3/11/2002
Inactive	Anthem Life Insurance Company	301209	Agent - Life	2/12/1999	3/11/2002
Inactive	Assurance Company of America	300432	Agent - Casualty	8/15/2000	3/11/2002
Inactive	Assurance Company of America	300432	Agent - General Lines	12/27/1999	8/15/2000
Inactive	Assurance Company of America	300432	Agent - Property	8/15/2000	3/11/2002
Denied	Banner Life Insurance Company	301696	Agent - Life
Inactive	Bedivere Insurance Company	300710	Agent - Casualty	8/15/2000	3/11/2002
Inactive	Bedivere Insurance Company	300710	Agent - General Lines	8/9/1996	8/15/2000
Inactive	Bedivere Insurance Company	300710	Agent - Property	8/15/2000	3/11/2002
Inactive	Berkshire Life Insurance Company	301158	Agent - Life	10/19/2000	7/1/2001
Inactive	Buckeye Union Insurance Company (The)	300597	Agent - General Lines	4/25/1997	3/31/1998
Inactive	CastlePoint National Insurance Company	300082	Agent - Casualty	8/15/2000	3/11/2002
Inactive	CastlePoint National Insurance Company	300082	Agent - General Lines	8/9/1996	8/15/2000
Inactive	CastlePoint National Insurance Company	300082	Agent - Property	8/15/2000	3/11/2002
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	1/8/2003	7/1/2006
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	12/19/2002	7/1/2006
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	2/2/2024
Inactive	Clarica Life Insurance Company - U.S.	300207	Agent - Health	7/28/1992	3/31/1997
Inactive	Clarica Life Insurance Company - U.S.	300207	Agent - Life	7/28/1992	3/31/1997
Active	Commerce and Industry Insurance Company	300881	Agent - Casualty	4/13/2007
Active	Commerce and Industry Insurance Company	300881	Agent - Property	4/13/2007
Inactive	Commercial Insurance Company of Newark, New Jersey	300328	Agent - General Lines	2/3/1997	3/31/1998
Inactive	Continental Casualty Company	301019	Agent - Casualty	8/15/2000	8/6/2001
Inactive	Continental Casualty Company	301019	Agent - General Lines	6/5/2000	8/15/2000
Inactive	Continental Casualty Company	301019	Agent - Property	8/15/2000	8/6/2001
Inactive	Continental Insurance Company (The)	301242	Agent - Casualty	8/15/2000	12/27/2001
Inactive	Continental Insurance Company (The)	301242	Agent - General Lines	1/31/1997	8/15/2000
Inactive	Continental Insurance Company (The)	301242	Agent - Property	8/15/2000	12/27/2001
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - General Lines	2/1/1997	12/30/1999
Inactive	First National Insurance Company of America	301690	Agent - General Lines	11/1/1998	6/28/2000
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	10/27/2000	3/11/2002
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	10/27/2000	3/11/2002
Inactive	General Insurance Company of America	300261	Agent - General Lines	11/1/1998	6/28/2000
Inactive	Glatfelter Insurance Company	301640	Agent - Casualty	8/15/2000	3/11/2002
Inactive	Glatfelter Insurance Company	301640	Agent - General Lines	12/27/1999	8/15/2000
Inactive	Glatfelter Insurance Company	301640	Agent - Property	8/15/2000	3/11/2002
Inactive	Glens Falls Insurance Company (The)	301922	Agent - General Lines	2/3/1997	12/30/1999
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	7/1/2001	7/1/2002
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/21/2006	11/20/2009
Inactive	Humana Insurance Company	301104	Agent - Health	12/21/2006	11/20/2009
Inactive	Humana Insurance Company	301104	Agent - Life	12/21/2006	11/20/2009
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/21/2006	11/20/2009
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/21/2006	11/20/2009
Inactive	Indianapolis Life Insurance Company	301381	Agent - Health	5/8/1991	12/30/1996
Inactive	Indianapolis Life Insurance Company	301381	Agent - Life	5/8/1991	12/30/1996
Active	Insurance Company of the State of Pennsylvania	300807	Agent - Casualty	4/13/2007
Active	Insurance Company of the State of Pennsylvania	300807	Agent - Property	4/13/2007
Inactive	John Alden Life Insurance Company	300573	Agent - Health	7/11/1991	10/31/1996
Inactive	John Alden Life Insurance Company	300573	Agent - Life	7/11/1991	10/31/1996
Inactive	Kansas City Fire and Marine Insurance Company	301936	Agent - General Lines	2/4/1997	12/30/1999
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	6/11/2018	8/23/2021
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	6/11/2018	8/23/2021
Inactive	Maryland Casualty Company	301719	Agent - Casualty	8/15/2000	3/11/2002
Inactive	Maryland Casualty Company	301719	Agent - General Lines	12/27/1999	8/15/2000
Inactive	Maryland Casualty Company	301719	Agent - Property	8/15/2000	3/11/2002
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	6/25/2001	7/1/2002
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	6/25/2001	7/1/2002
Inactive	Motors Insurance Corporation	300103	Agent - Casualty	7/24/2002	8/28/2002
Inactive	Motors Insurance Corporation	300103	Agent - Property	7/24/2002	8/28/2002
Active	Mutual of Omaha Insurance Company	301012	Agent - Health	5/17/2019
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Casualty	8/15/2000	8/6/2001
Inactive	National Fire Insurance Company of Hartford	301063	Agent - General Lines	6/5/2000	8/15/2000
Inactive	National Fire Insurance Company of Hartford	301063	Agent - Property	8/15/2000	8/6/2001
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	4/13/2007
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	4/13/2007
Inactive	NorGUARD Insurance Company	500015	Agent - Casualty	1/23/2019	2/18/2020
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	8/15/2000	3/11/2002
Inactive	Northern Insurance Company of New York	301317	Agent - General Lines	3/8/2000	8/15/2000
Inactive	Northern Insurance Company of New York	301317	Agent - Property	8/15/2000	3/11/2002
Inactive	Old Guard Insurance Company	533854	Agent - Casualty	6/3/2021	6/14/2021
Inactive	Old Guard Insurance Company	533854	Agent - Property	6/3/2021	6/14/2021
Inactive	Pennsylvania Insurance Company	301219	Agent - Casualty	8/15/2000	3/11/2002
Inactive	Pennsylvania Insurance Company	301219	Agent - General Lines	8/9/1996	8/15/2000
Inactive	Pennsylvania Insurance Company	301219	Agent - Property	8/15/2000	3/11/2002
Active	Principal National Life Insurance Company	301926	Agent - Life	5/9/2019
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	3/4/2003	12/8/2003
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	3/4/2003	12/8/2003
Inactive	Protective Life Insurance Company	300638	Agent - Health	6/26/2019	11/23/2021
Inactive	Protective Life Insurance Company	300638	Agent - Life	6/26/2019	11/23/2021
Inactive	Pruco Life Insurance Company	300954	Agent - Life	8/15/2018	11/23/2022
Denied	Reassure America Life Insurance Company	301902	Agent - Health
Denied	Reassure America Life Insurance Company	301902	Agent - Life
Inactive	SAFECO Insurance Company of America	300159	Agent - General Lines	11/1/1998	6/28/2000
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - General Lines	11/1/1998	6/28/2000
Inactive	Security National Insurance Company	301151	Agent - Casualty	7/27/2001	3/11/2002
Inactive	Security National Insurance Company	301151	Agent - Property	7/27/2001	3/11/2002
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Health	10/27/2000	3/11/2002
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Life	10/27/2000	3/11/2002
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Life	11/17/2000	7/1/2002
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	1/8/2003	7/1/2006
Inactive	The Phoenix Insurance Company	301502	Agent - Property	1/8/2003	7/1/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	7/26/2020	11/2/2023
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	7/26/2020	11/2/2023
Inactive	Transcontinental Insurance Company	301731	Agent - General Lines	2/5/1997	12/30/1999
Inactive	Transportation Insurance Company	301575	Agent - General Lines	2/1/1997	12/30/1999
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	1/8/2003	7/1/2006
Inactive	Travelers Indemnity Company (The)	301855	Agent - General Lines	5/30/2000	8/15/2000
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	1/8/2003	7/1/2006
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	1/8/2003	7/1/2006
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - General Lines	5/30/2000	8/15/2000
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	1/8/2003	7/1/2006
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	1/8/2003	7/1/2006
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	1/8/2003	7/1/2006
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	12/19/2002	7/1/2006
Inactive	Travelers Property Casualty Company of America	301649	Agent - General Lines	5/30/2000	8/15/2000
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	12/19/2002	7/1/2006
Inactive	Trinity Universal Insurance Company	300911	Agent - Casualty	7/27/2001	3/11/2002
Inactive	Trinity Universal Insurance Company	300911	Agent - Property	7/27/2001	3/11/2002
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Health	2/12/2001	7/1/2002
Inactive	U.S. Financial Life Insurance Company	301812	Agent - Life	2/12/2001	7/1/2002
Inactive	Valley Forge Insurance Company	301052	Agent - General Lines	2/3/1997	12/30/1999
Inactive	Westfield Champion Insurance Company	1054839	Agent - Casualty	6/3/2021	6/14/2021
Inactive	Westfield Champion Insurance Company	1054839	Agent - Property	6/3/2021	6/14/2021
Inactive	Westfield Insurance Company	301950	Agent - Casualty	11/18/2019	1/13/2025
Inactive	Westfield Insurance Company	301950	Agent - Property	11/18/2019	1/13/2025
Inactive	Westfield Premier Insurance Company	1055055	Agent - Casualty	6/3/2021	6/14/2021
Inactive	Westfield Premier Insurance Company	1055055	Agent - Property	6/3/2021	6/14/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Casualty	6/3/2021	6/14/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Property	6/3/2021	6/14/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Casualty	6/3/2021	6/14/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Property	6/3/2021	6/14/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	2/25/1999	7/1/2002
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	2/25/1999	7/1/2002
Inactive	Gordon & Brown Insurance Agency, Inc.	400377	Agent - General Lines	4/30/1993	8/15/2000
Inactive	Michelson Ins Group Inc	811576	Agent - Life	6/11/2018	3/31/2021
Inactive	Michelson Ins Group Inc	811576	Agent - Health	6/11/2018	3/31/2021
Inactive	Michelson Ins Group Inc	811576	Agent - Property	6/4/2013	3/31/2021
Inactive	Michelson Ins Group Inc	811576	Agent - Casualty	6/4/2013	3/31/2021
Active	PCF Insurance Services Of The West, LLC	976137	Agent - Life	8/11/2021
Active	PCF Insurance Services Of The West, LLC	976137	Agent - Health	8/11/2021
Active	PCF Insurance Services Of The West, LLC	976137	Agent - Property	8/11/2021
Active	PCF Insurance Services Of The West, LLC	976137	Agent - Casualty	8/11/2021
Inactive	Risco, Inc	649837	Property & Casualty Consultant - Not Applicable	2/20/2007	3/31/2017
Active	Risco, Inc	649837	Agent - Property	3/3/2025
Active	Risco, Inc	649837	Agent - Casualty	3/3/2025
Active	Risco, Inc	649837	Public Adjuster - Property & Casualty	9/8/2010
Active	Triple Crown Insurance, LLC	808123	Agent - Life	9/20/2019
Active	Triple Crown Insurance, LLC	808123	Agent - Health	9/20/2019
Active	Triple Crown Insurance, LLC	808123	Agent - Property	9/20/2019
Active	Triple Crown Insurance, LLC	808123	Agent - Casualty	9/20/2019
Inactive	Triple Crown Insurance, LLC	808123	Surplus Lines Broker - Not Applicable	9/20/2019	5/31/2020

Sponsorships

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Queen, Douglas Carey	725611	Apprentice Adjuster - Not Applicable	4/28/2010	4/28/2010