DEPARTMENT OF INSURANCE
Affiliations
NameGrossman, Keith JDOIID355867NAIC NPN1451711
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentVariable Life and Variable Annuities1/7/2025 7/31/2027
ActiveNon ResidentAgentLife1/7/2025 7/31/2027
* 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.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAllianz Life Insurance Company of North America301791Agent - Life8/28/19964/29/2021
InactiveAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities5/31/20014/23/2021
ActiveAthene Annuity and Life Company301893Agent - Life1/28/2025 
ActiveAthene Annuity and Life Company301893Agent - Variable Life and Variable Annuities1/28/2025 
InactiveAugustar Life Insurance Company301816Agent - Life11/30/200411/11/2010
InactiveAugustar Life Insurance Company301816Agent - Variable Life and Variable Annuities11/30/200411/11/2010
InactiveBrighthouse Life Insurance Company301829Agent - Life11/14/20147/31/2023
InactiveBrighthouse Life Insurance Company301829Agent - Variable Life and Variable Annuities11/14/20147/31/2023
InactiveEquitable Financial Life Insurance Company300808Agent - Life7/25/200312/23/2011
InactiveEquitable Financial Life Insurance Company300808Agent - Variable Life and Variable Annuities7/25/200312/23/2011
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life9/26/20084/29/2009
InactiveGenworth Life and Annuity Insurance Company301276Agent - Variable Life and Variable Annuities9/26/20084/29/2009
InactiveJackson National Life Insurance Company300486Agent - Life3/6/20077/31/2023
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities3/6/20077/31/2023
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life4/4/20034/18/2012
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Variable Life and Variable Annuities4/4/20034/18/2012
InactiveLincoln National Life Insurance Company (The)301382Agent - Life10/5/20078/3/2018
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities10/5/20078/3/2018
InactiveMetLife Investors Insurance Company301872Agent - Life5/22/199611/14/2014
InactiveMetLife Investors Insurance Company301872Agent - Variable Life and Variable Annuities9/10/200411/14/2014
InactivePruco Life Insurance Company300954Agent - Life10/2/199612/23/2014
InactivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities5/31/200112/23/2014
InactivePrudential Insurance Company of America300784Agent - Life11/15/199312/23/2014
InactivePrudential Insurance Company of America300784Agent - Variable Life and Variable Annuities5/31/200112/23/2014
InactiveTalcott Resolution Life Insurance Company301759Agent - Life6/16/199411/16/2011
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities5/31/200111/16/2011
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life3/11/199711/16/2011
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities5/31/200111/16/2011
InactiveTransamerica Life Insurance Company300571Agent - Life5/3/20058/3/2011
InactiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities5/3/20055/7/2013
InactiveTransamerica Occidental Life Insurance Company300966Agent - Life7/11/200310/1/2008
InactiveTransamerica Occidental Life Insurance Company300966Agent - Variable Life and Variable Annuities7/10/200310/1/2008
InactiveVenerable Insurance and Annuity Company301006Agent - Life9/25/20028/27/2008
InactiveVenerable Insurance and Annuity Company301006Agent - Variable Life and Variable Annuities9/25/20028/27/2008
InactiveVoya Retirement Insurance and Annuity Company300643Agent - Life4/12/20058/27/2008
InactiveVoya Retirement Insurance and Annuity Company300643Agent - Variable Life and Variable Annuities4/12/20058/27/2008
InactiveWestern National Life Insurance Company300461Agent - Life4/7/20089/25/2012
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactivePrudential Equity Group, LLC399017Agent - Life2/16/20043/4/2005
InactivePrudential Equity Group, LLC399017Agent - Variable Life and Variable Annuities2/16/20043/4/2005
ActiveWells Fargo Advisors Insurance Agency LLC399972Agent - Life3/5/2025 
ActiveWells Fargo Advisors Insurance Agency LLC399972Agent - Variable Life and Variable Annuities3/5/2025 

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