DEPARTMENT OF INSURANCE
Affiliations
NameCommunity Association Underwriters Of America, Inc.DOIID608111NAIC NPN686200
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth11/8/2019 3/31/2027
ActiveNon ResidentAgentCasualty1/28/2014 3/31/2027
ActiveNon ResidentAgentProperty1/28/2014 3/31/2027
ActiveNon ResidentAgentLife11/8/2019 3/31/2027
DeniedNon ResidentClass type not selected (Business Entity)Line of Authority not selected   
ActiveNon ResidentManaging General AgentNot Applicable7/6/2017 3/31/2027
ActiveNon ResidentSurplus Lines BrokerNot Applicable7/10/2017 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAmerican Alternative Insurance Corporation301697Agent - Casualty3/24/2017 
ActiveAmerican Alternative Insurance Corporation301697Agent - Property3/24/2017 
InactiveAmerican Economy Insurance Company300315Agent - Casualty11/9/20193/29/2024
InactiveAmerican Economy Insurance Company300315Agent - Property11/9/20193/29/2024
ActiveAmerican Family Home Insurance Company301817Agent - Casualty3/24/2017 
ActiveAmerican Family Home Insurance Company301817Agent - Property3/24/2017 
ActiveAmerican Home Assurance Company300246Agent - Casualty1/14/2025 
ActiveAmerican Home Assurance Company300246Agent - Property1/14/2025 
ActiveAmerican Southern Home Insurance Company626276Agent - Casualty3/24/2017 
ActiveAmerican Southern Home Insurance Company626276Agent - Property3/24/2017 
ActiveArch Insurance Company300688Agent - Casualty3/5/2025 
ActiveArch Insurance Company300688Agent - Health3/5/2025 
ActiveArch Insurance Company300688Agent - Property3/5/2025 
ActiveGranite State Insurance Company300818Agent - Casualty1/14/2025 
ActiveGranite State Insurance Company300818Agent - Property1/14/2025 
InactiveGreat American Insurance Company of New York301897Agent - Casualty3/7/20165/4/2021
InactiveGreat American Insurance Company of New York301897Agent - Property3/7/20165/4/2021
ActiveManufacturers Alliance Insurance Company519940Agent - Casualty3/6/2014 
ActiveManufacturers Alliance Insurance Company519940Agent - Property3/6/2014 
InactiveNational Union Fire Insurance Company of Pittsburgh, Pennsylvania300959Agent - Casualty8/4/20242/24/2025
InactiveNational Union Fire Insurance Company of Pittsburgh, Pennsylvania300959Agent - Property8/4/20242/24/2025
ActivePennsylvania Manufacturers Association Insurance Company300228Agent - Casualty3/6/2014 
ActivePennsylvania Manufacturers Association Insurance Company300228Agent - Property3/6/2014 
ActivePennsylvania Manufacturers Indemnity Company519939Agent - Casualty3/6/2014 
ActivePennsylvania Manufacturers Indemnity Company519939Agent - Property3/6/2014 
InactivePraetorian Insurance Company301021Agent - Casualty1/31/20148/11/2021
InactivePraetorian Insurance Company301021Agent - Property1/31/20148/11/2021
InactiveQBE Insurance Corporation300515Agent - Casualty1/31/20148/11/2021
ActiveQBE Insurance Corporation300515Agent - Health9/4/2020 
InactiveQBE Insurance Corporation300515Agent - Property1/31/20148/11/2021
InactiveSAFECO Insurance Company of America300159Agent - Casualty3/26/20193/29/2024
InactiveSAFECO Insurance Company of America300159Agent - Property3/26/20193/29/2024
InactiveSAFECO Insurance Company of Illinois301350Agent - Casualty3/26/20193/29/2024
InactiveSAFECO Insurance Company of Illinois301350Agent - Property3/26/20193/29/2024
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBell, Adam Michael George 1004937Agent - Casualty7/10/20194/22/2020
InactiveBell, Adam Michael George 1004937Agent - Property7/10/20194/22/2020
InactiveBlasch, Mark E 330938Agent - Casualty6/14/20051/16/2014
InactiveBlasch, Mark E 330938Agent - Property6/14/20051/16/2014
ActiveHenken, Douglas 1028573Agent - Casualty5/30/2019 
ActiveHenken, Douglas 1028573Agent - Health11/8/2019 
ActiveHenken, Douglas 1028573Agent - Life11/8/2019 
ActiveHenken, Douglas 1028573Agent - Property5/30/2019 
ActiveHenken, Douglas 1028573Surplus Lines Broker - Not Applicable4/22/2020 
ActiveLong, Lori Ann 827578Agent - Casualty1/28/2014 
ActiveLong, Lori Ann 827578Agent - Property1/28/2014 
InactiveMorgan, Mark Douglas 1031736Agent - Casualty5/30/20192/13/2020
InactiveMorgan, Mark Douglas 1031736Agent - Property5/30/20192/13/2020
InactiveMorgan, Mark Douglas 1031736Surplus Lines Broker - Not Applicable5/30/20194/22/2020
DeniedNugent, Ashley V 1320549Agent - Casualty  
DeniedNugent, Ashley V 1320549Agent - Property  
InactiveTravis, Robert A 761222Agent - Casualty7/6/20175/30/2019
InactiveTravis, Robert A 761222Agent - Health4/24/20155/30/2019
InactiveTravis, Robert A 761222Agent - Property7/6/20175/30/2019
DeniedTravis, Robert A 761222Managing General Agent - Not Applicable  
InactiveTravis, Robert A 761222Surplus Lines Broker - Not Applicable7/10/20174/22/2020
InactiveTufano, Matthew Erich 1044449Agent - Casualty7/10/20199/23/2019
InactiveTufano, Matthew Erich 1044449Agent - Property7/10/20199/23/2019

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