DEPARTMENT OF INSURANCE

Affiliations

Name	Affinity Group Underwriters Inc	DOIID	400262	NAIC NPN	1913693

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	3/11/2000	3/31/2003
Active	Non Resident	Agent	Life	8/23/1999		3/31/2027
Active	Non Resident	Agent	Health	8/23/1999		3/31/2027
Inactive	Non Resident	Agent	Property	7/12/2017	9/1/2019
Inactive	Non Resident	Agent	Casualty	7/12/2017	9/1/2019
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	7/12/2017	9/1/2019
* 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	ACE American Insurance Company	300625	Agent - Health	9/7/2007
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Amalgamated Life Insurance Company	701415	Agent - Health	12/27/2022
Active	Amalgamated Life Insurance Company	701415	Agent - Life	12/27/2022
Active	Banner Life Insurance Company	301696	Agent - Life	8/23/2013
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	11/8/2010	7/20/2012
Inactive	CompBenefits Insurance Company	301864	Agent - Health	11/8/2010	7/20/2012
Inactive	CompBenefits Insurance Company	301864	Agent - Life	11/8/2010	7/20/2012
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	11/8/2010	7/20/2012
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	3/12/2001
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	3/12/2001
Inactive	First Allmerica Financial Life Insurance Company	301853	Agent - Health	8/23/1999	6/4/2006
Inactive	First Allmerica Financial Life Insurance Company	301853	Agent - Life	8/23/1999	6/4/2006
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/8/2010	7/20/2012
Inactive	Humana Insurance Company	301104	Agent - Health	11/8/2010	7/20/2012
Inactive	Humana Insurance Company	301104	Agent - Life	11/8/2010	7/20/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/8/2010	7/20/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/8/2010	7/20/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Health	11/8/2010	2/24/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	11/8/2010	2/24/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/8/2010	7/20/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/8/2010	7/20/2012
Active	Life Insurance Company of North America	300711	Agent - Health	3/14/2000
Active	Life Insurance Company of North America	300711	Agent - Life	3/14/2000
Inactive	Life Investors Insurance Company of America	301793	Agent - Health	11/14/2000	5/20/2002
Inactive	Life Investors Insurance Company of America	301793	Agent - Life	11/20/2000	5/20/2002
Inactive	Markel Insurance Company	301475	Agent - Health	11/1/2001	9/20/2007
Inactive	Principal Life Insurance Company	300129	Agent - Health	11/27/2000	11/19/2009
Inactive	Principal Life Insurance Company	300129	Agent - Life	11/27/2000	11/19/2009
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	11/20/2000	5/20/2002
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	11/20/2000	5/20/2002
Active	United States Fire Insurance Company	582240	Agent - Health	5/13/2013
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	7/19/2001	4/5/2004
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	7/19/2001	4/5/2004
Inactive	West Coast Life Insurance Company	301607	Agent - Life	3/26/2004	11/16/2011
Inactive	Wilcac Life Insurance Company	301573	Agent - Health	8/23/2001	8/10/2005
Inactive	Wilcac Life Insurance Company	301573	Agent - Life	8/23/2001	8/10/2005
Active	Zurich American Insurance Company	301121	Agent - Health	6/21/2012

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Parrish, Emma Salmon	509532	Administrator - Not Applicable	3/11/2000	3/31/2003
Inactive	Parrish, Emma Salmon	509532	Agent - Casualty	7/12/2017	6/30/2019
Inactive	Parrish, Emma Salmon	509532	Agent - Property	7/12/2017	6/30/2019
Inactive	Parrish, Emma Salmon	509532	Surplus Lines Broker - Not Applicable	7/12/2017	6/30/2019
Inactive	Wyss, Stephen L	366834	Administrator - Not Applicable	3/11/2000	3/31/2003
Active	Wyss, Stephen L	366834	Agent - Health	5/19/2003
Active	Wyss, Stephen L	366834	Agent - Life	5/19/2003