DEPARTMENT OF INSURANCE

Affiliations

Name	Crum, Michael L	DOIID	355397	NAIC NPN	1494751

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	10/15/1993	2/28/2010
Active	Non Resident	Agent	Health	6/27/1996		2/28/2026
Active	Non Resident	Agent	Life	6/27/1996		2/28/2026
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	5/13/2015
Active	Aetna Life Insurance Company	301140	Agent - Health	5/13/2015
Active	Aetna Life Insurance Company	301140	Agent - Life	5/13/2015
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	2/25/2003	11/29/2004
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	2/25/2003	11/29/2004
Inactive	American Fidelity Assurance Company	301004	Agent - Health	8/8/2007	8/16/2010
Inactive	American Fidelity Assurance Company	301004	Agent - Life	8/8/2007	8/16/2010
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	11/8/2007	12/27/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	11/8/2007	12/27/2012
Inactive	Arch Insurance Company	300688	Agent - Health	6/17/2003	11/8/2006
Inactive	Canada Life Assurance Company	301192	Agent - Health	5/11/2007	2/5/2009
Inactive	Canada Life Assurance Company	301192	Agent - Life	5/11/2007	2/5/2009
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	7/28/2009	9/8/2010
Inactive	CompBenefits Insurance Company	301864	Agent - Health	7/28/2009	9/8/2010
Inactive	CompBenefits Insurance Company	301864	Agent - Life	7/28/2009	9/8/2010
Inactive	Companion Life Insurance Company	300191	Agent - Health	2/11/2009	9/22/2009
Inactive	Companion Life Insurance Company	300191	Agent - Life	2/11/2009	9/22/2009
Inactive	Continental Insurance Company (The)	301242	Agent - Health	11/14/2000	11/7/2003
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	4/3/1998	9/17/2001
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	4/3/1998	9/17/2001
Inactive	First Allmerica Financial Life Insurance Company	301853	Agent - Health	1/13/1998	12/29/2005
Inactive	First Allmerica Financial Life Insurance Company	301853	Agent - Life	1/13/1998	12/29/2005
Inactive	HCC Life Insurance Company	301827	Agent - Health	6/27/1996	8/4/2010
Inactive	HCC Life Insurance Company	301827	Agent - Life	6/27/1996	8/4/2010
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	2/15/2001	12/8/2009
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	2/21/2001	12/8/2009
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/14/2008	9/8/2010
Inactive	Humana Insurance Company	301104	Agent - Health	3/14/2008	9/8/2010
Inactive	Humana Insurance Company	301104	Agent - Life	3/14/2008	9/8/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Health	3/14/2008	9/8/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Life	3/14/2008	9/8/2010
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	8/27/2003	5/3/2013
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	8/7/2009
Inactive	Nationwide Life Insurance Company	300495	Agent - Health	10/19/2009	10/9/2013
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	10/19/2009	10/9/2013
Inactive	Protective Life Insurance Company	300638	Agent - Health	8/28/2000	12/15/2003
Inactive	Protective Life Insurance Company	300638	Agent - Life	8/28/2000	12/15/2003
Inactive	QBE Insurance Corporation	300515	Agent - Health	1/12/2004	9/10/2021
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	11/27/2000	11/3/2007
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	11/27/2000	11/3/2007
Inactive	Security Life of Denver Insurance Company	300648	Agent - Life	10/1/2004	2/14/2005
Inactive	Southland Life Insurance Company	301175	Agent - Life	10/14/1997	10/1/2004
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	8/13/2003	11/22/2005
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	8/13/2003	11/22/2005
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Health	11/8/2006	8/22/2011
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Life	11/8/2006	8/22/2011
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Health	4/9/2004	12/15/2006
Inactive	Sun Life and Health Insurance Company (U.S.)	300801	Agent - Life	4/9/2004	12/15/2006
Inactive	Symetra Life Insurance Company	301691	Agent - Health	2/3/1999	4/20/2009
Inactive	Symetra Life Insurance Company	301691	Agent - Life	2/3/1999	4/20/2009
Inactive	Unimerica Insurance Company	563724	Agent - Health	9/14/2009	12/14/2009
Inactive	Unimerica Insurance Company	563724	Agent - Life	9/14/2009	12/14/2009
Inactive	Union Security Insurance Company	301844	Agent - Health	2/7/2002	2/5/2021
Inactive	Union Security Insurance Company	301844	Agent - Life	2/7/2002	2/5/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	8/27/2003	5/3/2013
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	8/27/2003	5/3/2013
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/31/2006	12/14/2009
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	7/31/2006	12/14/2009
Inactive	Westport Insurance Corporation	301875	Agent - Health	7/13/2001	9/26/2006
Inactive	Wilcac Life Insurance Company	301573	Agent - Life	8/28/2000	11/7/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dental Choice Agency Inc.	398085	Agent - Health	12/22/2004	1/8/2014
Inactive	Medben Marketing Services Inc.	398697	Agent - Life	12/11/1997	9/26/2017
Inactive	Medben Marketing Services Inc.	398697	Agent - Health	12/11/1997	9/26/2017
Inactive	Medical Benefits Administrators Inc.	395813	Administrator - Not Applicable	10/15/1993	5/31/2003