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	3/31/2025
Active	Non Resident	Agent	Casualty	7/19/2002	3/31/2025
Active	Non Resident	Agent	Life	10/23/2001	3/31/2025
Active	Non Resident	Agent	Property	7/19/2002	3/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2025	03/31/2025

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