DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	The Brokers Source Ltd	DOIID	608649	NAIC NPN	957440

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	7/25/2011		3/31/2025
Active	Non Resident	Agent	Health	7/25/2011		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
Active	Banner Life Insurance Company	301696	Agent - Life	5/24/2012
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Health	9/8/2017
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	9/8/2017
Active	Gerber Life Insurance Company	300529	Agent - Health	2/9/2023
Active	Gerber Life Insurance Company	300529	Agent - Life	2/9/2023
Active	Metropolitan Life Insurance Company	301948	Agent - Health	1/27/2016
Active	Metropolitan Life Insurance Company	301948	Agent - Life	1/27/2016
Active	Pacific Life Insurance Company	301848	Agent - Life	3/20/2017
Active	Protective Life Insurance Company	300638	Agent - Health	8/4/2011
Active	Protective Life Insurance Company	300638	Agent - Life	8/4/2011
Active	Pruco Life Insurance Company	300954	Agent - Health	4/7/2022
Active	Pruco Life Insurance Company	300954	Agent - Life	4/7/2022
Active	Reliance Standard Life Insurance Company	300584	Agent - Health	6/27/2018
Active	Reliance Standard Life Insurance Company	300584	Agent - Life	6/27/2018
Active	State Life Insurance Company	301497	Agent - Health	4/9/2016
Active	State Life Insurance Company	301497	Agent - Life	4/9/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Haynes, Pryce Middleton	735644	Agent - Health	8/30/2017
Active	Haynes, Pryce Middleton	735644	Agent - Life	8/30/2017
Inactive	Phillips, Raymond S	608481	Agent - Health	7/25/2011	11/23/2017
Inactive	Phillips, Raymond S	608481	Agent - Life	7/25/2011	11/23/2017
Inactive	Pifer, Jeffrey E	860234	Agent - Life	12/18/2014	8/31/2016
Inactive	Young, Richard A	583846	Agent - Life	11/5/2013	11/2/2015