DEPARTMENT OF INSURANCE

Affiliations

Name	Premier Insurance Management Services, Inc.	DOIID	540070	NAIC NPN	14748749

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	10/23/2001	3/31/2027
Active	Non Resident	Agent	Property	7/19/2002	3/31/2027
Active	Non Resident	Agent	Casualty	7/19/2002	3/31/2027
Active	Non Resident	Agent	Life	10/23/2001	3/31/2027
* 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
Inactive	American General Assurance Company	300586	Agent - Health	12/31/2002	12/31/2012
Inactive	American General Assurance Company	300586	Agent - Life	12/31/2002	12/31/2012
Inactive	American General Life Insurance Company	301585	Agent - Health	12/31/2012	12/2/2016
Inactive	American General Life Insurance Company	301585	Agent - Life	12/31/2012	12/2/2016
Inactive	American General Life Insurance Company of Pennsylvania	301579	Agent - Health	4/8/2002	12/31/2002
Inactive	American General Life Insurance Company of Pennsylvania	301579	Agent - Life	4/8/2002	12/31/2002
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	5/29/2019
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	5/29/2019
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	7/26/2006	5/18/2008
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	7/26/2006	5/18/2008
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	10/23/2001	11/30/2023
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	10/23/2001	11/30/2023
Active	Safety National Casualty Corporation	300390	Agent - Casualty	3/1/2004
Active	Safety National Casualty Corporation	300390	Agent - Property	3/1/2004
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	8/26/2004	11/30/2023
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	8/26/2004	11/30/2023
Active	Zurich American Insurance Company	301121	Agent - Casualty	7/19/2002
Active	Zurich American Insurance Company	301121	Agent - Property	7/19/2002

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Albert, Edward Vernon	392894	Agent - Casualty	7/19/2002	2/19/2007
Inactive	Albert, Edward Vernon	392894	Agent - Health	10/23/2001	2/19/2007
Inactive	Albert, Edward Vernon	392894	Agent - Life	10/23/2001	2/19/2007
Inactive	Albert, Edward Vernon	392894	Agent - Property	7/19/2002	2/19/2007
Denied	Cary, Phillip Aaron	872616	Agent - Casualty
Denied	Cary, Phillip Aaron	872616	Agent - Health
Denied	Cary, Phillip Aaron	872616	Agent - Life
Denied	Cary, Phillip Aaron	872616	Agent - Property
Inactive	Dowdy, Robert Luis	573162	Agent - Casualty	1/24/2005	6/16/2010
Inactive	Dowdy, Robert Luis	573162	Agent - Health	2/15/2005	6/16/2010
Inactive	Dowdy, Robert Luis	573162	Agent - Life	2/15/2005	6/16/2010
Inactive	Dowdy, Robert Luis	573162	Agent - Property	1/24/2005	6/16/2010
Inactive	Green, Thomas Michael	540058	Agent - Casualty	7/19/2002	6/4/2019
Inactive	Green, Thomas Michael	540058	Agent - Health	6/22/2010	6/4/2019
Inactive	Green, Thomas Michael	540058	Agent - Life	6/22/2010	6/4/2019
Inactive	Green, Thomas Michael	540058	Agent - Property	7/19/2002	6/4/2019
Inactive	Hood, Joan Marie	540063	Agent - Casualty	7/19/2002	2/25/2005
Inactive	Hood, Joan Marie	540063	Agent - Health	10/23/2001	2/25/2005
Inactive	Hood, Joan Marie	540063	Agent - Life	10/23/2001	2/25/2005
Inactive	Hood, Joan Marie	540063	Agent - Property	7/19/2002	2/25/2005
Denied	Norman, Kelly C	633321	Agent - Health
Denied	Norman, Kelly C	633321	Agent - Life
Denied	Parker, Belinda M	1036722	Agent - Casualty
Denied	Parker, Belinda M	1036722	Agent - Property
Inactive	Poremba, Michael Peter	552321	Agent - Casualty	7/19/2002	1/15/2016
Inactive	Poremba, Michael Peter	552321	Agent - Property	7/19/2002	1/15/2016
Active	Wozny, Ann R	536166	Agent - Casualty	12/14/2016
Active	Wozny, Ann R	536166	Agent - Health	5/29/2019
Active	Wozny, Ann R	536166	Agent - Life	5/29/2019
Active	Wozny, Ann R	536166	Agent - Property	12/14/2016