DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Aia American Insurance Administrators, LLC	DOIID	600855	NAIC NPN	1990436

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/6/2023		3/31/2025
Active	Non Resident	Agent	Life	10/6/2016		3/31/2025
Active	Non Resident	Agent	Health	10/6/2016		3/31/2025
Active	Non Resident	Agent	Casualty	3/6/2023		3/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	6/14/2024		3/31/2027
* 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
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	12/16/2017
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/10/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	12/16/2017
Active	Aetna Life Insurance Company	301140	Agent - Life	12/16/2017
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	10/10/2023
Active	Colonial Life and Accident Insurance Company	300846	Agent - Health	2/17/2020
Active	Colonial Life and Accident Insurance Company	300846	Agent - Life	2/17/2020
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018
Active	First Health Life & Health Insurance Company	301735	Agent - Health	12/16/2017
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	6/6/2017
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	6/6/2017
Active	SilverScript Insurance Company	663526	Agent - Health	10/19/2019
Active	UNUM Life Insurance Company of America	300817	Agent - Health	6/6/2017
Active	UNUM Life Insurance Company of America	300817	Agent - Life	6/6/2017
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	3/8/2019	5/13/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Breon, Toby G	1240219	Agent - Casualty	9/21/2023
Active	Breon, Toby G	1240219	Agent - Health	9/21/2023
Active	Breon, Toby G	1240219	Agent - Life	10/10/2023
Active	Breon, Toby G	1240219	Agent - Property	9/21/2023
Active	Dardick, David Scott	1263663	Agent - Health	4/13/2023
Active	Dardick, David Scott	1263663	Agent - Life	4/13/2023
Inactive	Dorsheimer, Dan G	599584	Agent - Health	10/6/2016	4/30/2019
Inactive	Dorsheimer, Dan G	599584	Agent - Life	10/6/2016	4/30/2019
Active	Krause, Kevin L	984277	Agent - Health	8/31/2018
Active	Krause, Kevin L	984277	Agent - Life	8/31/2018
Active	Levitz, Alan J	312664	Agent - Health	10/30/2018
Active	Levitz, Alan J	312664	Agent - Life	10/30/2018
Denied	Straw, William Thomas	1197926	Agent - Health
Denied	Straw, William Thomas	1197926	Agent - Life
Active	Wert, Christopher Frantz	1256542	Agent - Casualty	3/6/2023
Active	Wert, Christopher Frantz	1256542	Agent - Property	3/6/2023
Active	Wert, Christopher Frantz	1256542	Surplus Lines Broker - Not Applicable	6/14/2024