DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Rose, Richard	DOIID	560056	NAIC NPN	5567122

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	2/14/2024		1/31/2026
Active	Non Resident	Agent	Life	2/14/2024		1/31/2026
Active	Non Resident	Agent	Health	2/14/2024		1/31/2026
Active	Non Resident	Agent	Property	2/14/2024		1/31/2026
* 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	Hartford Fire Insurance Company	300628	Agent - Health	4/4/2024
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	4/19/2024
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	4/19/2024
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	1/29/2009	1/31/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	1/29/2009	1/31/2012
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	12/10/2002	11/10/2004
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	12/10/2002	11/10/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	5/16/2005	9/2/2010
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	5/16/2005	9/2/2010