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	Health	7/9/1997		11/30/2025
Active	Non Resident	Agent	Life	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.

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
Active	Anthem Life Insurance Company	301209	Agent - Health	2/11/2015
Active	Anthem Life Insurance Company	301209	Agent - Life	2/11/2015
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
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	4/12/2004
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	4/12/2004
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
Active	Designated Agent Company Inc.	681257	Agent - Life	2/11/2015
Active	Designated Agent Company Inc.	681257	Agent - Health	2/11/2015
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