DEPARTMENT OF INSURANCE

Affiliations

Name	Verschoor, Susan S	DOIID	338924	NAIC NPN	1167174

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	7/9/1997		11/30/2025
Active	Non Resident	Agent	Health	7/9/1997		11/30/2025
Inactive	Non Resident	Agent	Health Maintenance Organization	7/11/1997	5/19/1999
Active	Non Resident	Life & Health Consultant	Not Applicable	8/9/2006		11/30/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	09/15/2025	11/30/2025
Life & Health Consultant	09/15/2025	11/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	All Savers Insurance Company	301940	Agent - Health	4/29/2024
Active	All Savers Insurance Company	301940	Agent - Life	4/29/2024
Inactive	American Fidelity Assurance Company	301004	Agent - Health	8/28/2002	9/7/2006
Inactive	American Fidelity Assurance Company	301004	Agent - Life	8/28/2002	9/7/2006
Inactive	American Sentinel Insurance Company	519097	Agent - Health	9/16/2005	5/5/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Health	2/11/2015	12/17/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Life	2/11/2015	12/17/2024
Inactive	Banner Life Insurance Company	301696	Agent - Life	5/12/2004	2/20/2007
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	2/13/2020	6/16/2022
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	2/13/2020	6/16/2022
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/29/2014	12/13/2016
Inactive	Continental Insurance Company (The)	301242	Agent - Health	7/17/2000	11/10/2003
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/29/2014	12/8/2015
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	12/3/2008
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	12/3/2008
Inactive	First Colony Life Insurance Company	301179	Agent - Health	6/27/2006	1/1/2007
Inactive	First Colony Life Insurance Company	301179	Agent - Life	6/27/2006	1/1/2007
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	1/1/2007	12/9/2008
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	12/9/2008
Active	Guardian Life Insurance Company of America	301316	Agent - Health	2/13/2020
Active	Guardian Life Insurance Company of America	301316	Agent - Life	2/13/2020
Inactive	Hartford Life Group Insurance Company	301708	Agent - Health	11/4/2005	12/31/2006
Inactive	Hartford Life Group Insurance Company	301708	Agent - Life	11/4/2005	12/31/2006
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	4/12/2004	11/27/2024
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	4/12/2004	11/27/2024
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/29/2014	12/8/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	7/11/1997	5/19/1999
Inactive	Humana Insurance Company	301104	Agent - Health	10/29/2014	12/8/2015
Inactive	Humana Insurance Company	301104	Agent - Life	10/29/2014	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/29/2014	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/29/2014	12/8/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	10/29/2014	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	10/29/2014	10/22/2015
Active	Life Insurance Company of North America	300711	Agent - Health	6/11/2007
Active	Life Insurance Company of North America	300711	Agent - Life	6/11/2007
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	12/18/2012
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	12/18/2012
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Health	10/7/2008	3/11/2010
Inactive	Madison National Life Insurance Company Inc.	301458	Agent - Life	10/7/2008	3/11/2010
Inactive	Markel Insurance Company	301475	Agent - Health	12/19/2002	3/15/2006
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	2/6/2003	12/21/2013
Inactive	Penn Mutual Life Insurance Company	301394	Agent - Health	12/26/2002	8/8/2006
Inactive	Penn Mutual Life Insurance Company	301394	Agent - Life	12/26/2002	8/8/2006
Inactive	Principal Life Insurance Company	300129	Agent - Health	12/11/2002	11/25/2009
Inactive	Principal Life Insurance Company	300129	Agent - Life	12/11/2002	11/25/2009
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	7/11/2016	11/30/2023
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	7/11/2016	11/30/2023
Inactive	QBE Insurance Corporation	300515	Agent - Health	4/6/2017	4/5/2022
Inactive	Standard Insurance Company	300185	Agent - Health	12/27/2002	2/10/2005
Inactive	Standard Insurance Company	300185	Agent - Life	12/27/2002	2/10/2005
Active	Sun Life Assurance Company of Canada	301811	Agent - Health	7/19/2013
Active	Sun Life Assurance Company of Canada	301811	Agent - Life	7/19/2013
Inactive	Symetra Life Insurance Company	301691	Agent - Health	7/16/2001	4/17/2015
Inactive	Symetra Life Insurance Company	301691	Agent - Life	7/16/2001	4/17/2015
Inactive	Transamerica Assurance Company	300893	Agent - Health	2/21/2003	10/1/2004
Inactive	Transamerica Assurance Company	300893	Agent - Life	2/21/2003	10/1/2004
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	5/17/2004	5/8/2006
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	5/17/2004	5/8/2006
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	7/11/2016	11/30/2023
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	7/11/2016	11/30/2023
Active	United of Omaha Life Insurance Company	300156	Agent - Health	2/12/2003
Active	United of Omaha Life Insurance Company	300156	Agent - Life	2/12/2003
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	4/29/2024
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	4/29/2024
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	4/29/2024
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	4/29/2024
Inactive	West Coast Life Insurance Company	301607	Agent - Life	4/20/2004	12/27/2005
Inactive	Wilcac Life Insurance Company	301573	Agent - Health	7/17/2000	11/10/2003
Inactive	Wilcac Life Insurance Company	301573	Agent - Life	7/17/2000	11/10/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dental Choice Agency Inc.	398085	Agent - Health	8/29/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Life	2/11/2015	2/11/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Health	2/11/2015	2/11/2025
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	1/7/2010	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	1/7/2010	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Life & Health Consultant - Not Applicable	10/31/2011	10/9/2019
Active	Usi Insurance Services LLC	669260	Agent - Life	12/27/2018
Active	Usi Insurance Services LLC	669260	Agent - Health	12/27/2018
Active	Usi Insurance Services LLC	669260	Life & Health Consultant - Not Applicable	12/27/2018
Inactive	Wells Fargo Ins Services Of Ohio LLC	521675	Agent - Life	2/13/2003	3/15/2010
Inactive	Wells Fargo Ins Services Of Ohio LLC	521675	Agent - Health	2/13/2003	3/12/2010
Inactive	Wells Fargo Ins Services Of Ohio LLC	521675	Life & Health Consultant - Not Applicable	6/30/2008	3/12/2010