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DEPARTMENT OF INSURANCE
Affiliations
Name
Mainsource Ins LLC
DOIID
612543
NAIC NPN
8386928
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Non Resident
Agent
Property
9/26/2005
3/31/2017
Inactive
Non Resident
Agent
Casualty
9/26/2005
3/31/2017
Inactive
Non Resident
Agent
Life
12/4/2009
8/1/2011
Inactive
Non Resident
Agent
Health
12/4/2009
3/31/2017
* 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
Inactive
American Family Life Assurance Company of Columbus (AFLAC)
301781
Agent - Health
12/20/2005
10/1/2009
Inactive
American Family Life Assurance Company of Columbus (AFLAC)
301781
Agent - Life
12/20/2005
10/1/2009
Inactive
American Fire and Casualty Company
300567
Agent - Casualty
4/6/2011
3/31/2017
Inactive
American Fire and Casualty Company
300567
Agent - Property
4/6/2011
3/31/2017
Inactive
American National Insurance Company
301861
Agent - Health
8/27/2008
10/1/2009
Inactive
American National Insurance Company
301861
Agent - Life
8/27/2008
10/1/2009
Inactive
Anthem Health Plans of Kentucky, Inc.
300999
Agent - Health
12/15/2009
5/17/2017
Inactive
Anthem Insurance Companies, Inc.
300941
Agent - Health
12/15/2009
10/16/2012
Inactive
Anthem Life Insurance Company
301209
Agent - Health
12/15/2009
5/17/2017
Inactive
Anthem Life Insurance Company
301209
Agent - Life
12/15/2009
8/1/2011
Inactive
Athene Annuity & Life Assurance Company of New York
300724
Agent - Life
2/4/2008
10/1/2009
Inactive
Auto-Owners Insurance Company
301480
Agent - Casualty
7/6/2009
12/20/2010
Inactive
Auto-Owners Insurance Company
301480
Agent - Property
7/6/2009
12/20/2010
Inactive
Automobile Insurance Company of Hartford, Connecticut
300630
Agent - Casualty
12/15/2009
3/23/2011
Inactive
Automobile Insurance Company of Hartford, Connecticut
300630
Agent - Property
12/15/2009
3/23/2011
Inactive
Banner Life Insurance Company
301696
Agent - Life
1/15/2010
8/1/2011
Inactive
Consolidated Insurance Company
300943
Agent - Casualty
2/22/2007
3/31/2017
Inactive
Consolidated Insurance Company
300943
Agent - Property
2/22/2007
3/31/2017
Inactive
First National Insurance Company of America
301690
Agent - Casualty
10/16/2008
3/31/2017
Inactive
First National Insurance Company of America
301690
Agent - Property
10/16/2008
3/31/2017
Inactive
General Insurance Company of America
300261
Agent - Casualty
10/16/2008
3/31/2017
Inactive
General Insurance Company of America
300261
Agent - Property
10/16/2008
3/31/2017
Inactive
Golden Rule Insurance Company
301943
Agent - Health
3/4/2009
10/1/2009
Inactive
Golden Rule Insurance Company
301943
Agent - Life
3/4/2009
10/1/2009
Inactive
Hallmark National Insurance Company
300494
Agent - Casualty
5/4/2006
12/31/2010
Inactive
Hallmark National Insurance Company
300494
Agent - Property
5/4/2006
12/31/2010
Inactive
Hanover Insurance Company (The)
300508
Agent - Casualty
11/21/2005
3/30/2006
Inactive
Hanover Insurance Company (The)
300508
Agent - Property
11/21/2005
3/30/2006
Inactive
Indiana Insurance Company
301909
Agent - Casualty
2/22/2007
3/31/2017
Inactive
Indiana Insurance Company
301909
Agent - Property
2/22/2007
3/31/2017
Inactive
Integrity Life Insurance Company
301687
Agent - Life
8/11/2008
10/1/2009
Inactive
Massachusetts Bay Insurance Company
300898
Agent - Casualty
11/21/2005
3/30/2006
Inactive
Massachusetts Bay Insurance Company
300898
Agent - Property
11/21/2005
3/30/2006
Inactive
Meridian Citizens Mutual Insurance Company
300935
Agent - Casualty
5/4/2006
12/31/2010
Inactive
Meridian Citizens Mutual Insurance Company
300935
Agent - Property
5/4/2006
12/31/2010
Inactive
Meridian Security Insurance Company
300423
Agent - Casualty
2/6/2007
12/31/2010
Inactive
Meridian Security Insurance Company
300423
Agent - Property
2/6/2007
12/31/2010
Inactive
Netherlands Insurance Company (The)
300339
Agent - Casualty
2/22/2007
3/31/2017
Inactive
Netherlands Insurance Company (The)
300339
Agent - Property
2/22/2007
3/31/2017
Inactive
Ohio Casualty Insurance Company
301492
Agent - Casualty
12/3/2010
3/31/2017
Inactive
Ohio Casualty Insurance Company
301492
Agent - Property
12/3/2010
3/31/2017
Inactive
Ohio Security Insurance Company
300622
Agent - Casualty
4/6/2011
3/31/2017
Inactive
Ohio Security Insurance Company
300622
Agent - Property
4/6/2011
3/31/2017
Inactive
Omni Indemnity Company
301456
Agent - Casualty
10/26/2005
10/20/2009
Inactive
Omni Indemnity Company
301456
Agent - Property
10/26/2005
10/20/2009
Inactive
Omni Insurance Company
301545
Agent - Casualty
10/26/2005
10/28/2009
Inactive
Omni Insurance Company
301545
Agent - Property
10/26/2005
10/28/2009
Inactive
Owners Insurance Company
300796
Agent - Casualty
7/6/2009
12/20/2010
Inactive
Owners Insurance Company
300796
Agent - Property
7/6/2009
12/20/2010
Inactive
Peerless Insurance Company
301910
Agent - Casualty
2/22/2007
3/31/2017
Inactive
Peerless Insurance Company
301910
Agent - Property
2/22/2007
3/31/2017
Inactive
Progressive Casualty Insurance Company
300696
Agent - Casualty
8/9/2006
2/18/2011
Inactive
Progressive Casualty Insurance Company
300696
Agent - Property
8/9/2006
2/18/2011
Inactive
Progressive Northern Insurance Company
301378
Agent - Casualty
8/9/2006
2/18/2011
Inactive
Progressive Northern Insurance Company
301378
Agent - Property
8/9/2006
2/18/2011
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Health
8/18/2008
10/1/2009
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Life
8/18/2008
10/1/2009
Inactive
SAFECO Insurance Company of America
300159
Agent - Casualty
10/16/2008
3/31/2017
Inactive
SAFECO Insurance Company of America
300159
Agent - Property
10/16/2008
3/31/2017
Inactive
SAFECO Insurance Company of Illinois
301350
Agent - Casualty
10/16/2008
3/31/2017
Inactive
SAFECO Insurance Company of Illinois
301350
Agent - Property
10/16/2008
3/31/2017
Inactive
Standard Fire Insurance Company (The)
301068
Agent - Casualty
12/15/2009
1/12/2011
Inactive
Standard Fire Insurance Company (The)
301068
Agent - Property
12/15/2009
1/12/2011
Inactive
State Auto Property & Casualty Insurance Company
301953
Agent - Casualty
5/4/2006
12/31/2010
Inactive
State Auto Property & Casualty Insurance Company
301953
Agent - Property
5/4/2006
12/31/2010
Inactive
State Automobile Mutual Insurance Company
301824
Agent - Casualty
5/4/2006
12/31/2010
Inactive
State Automobile Mutual Insurance Company
301824
Agent - Property
5/4/2006
12/31/2010
Inactive
The Phoenix Insurance Company
301502
Agent - Casualty
12/15/2009
1/12/2011
Inactive
The Phoenix Insurance Company
301502
Agent - Property
12/15/2009
1/12/2011
Inactive
Travelers Commercial Insurance Company
301506
Agent - Casualty
12/15/2009
3/23/2011
Inactive
Travelers Commercial Insurance Company
301506
Agent - Property
12/15/2009
3/23/2011
Inactive
Travelers Home and Marine Insurance Company (The)
301802
Agent - Casualty
12/15/2009
3/23/2011
Inactive
Travelers Home and Marine Insurance Company (The)
301802
Agent - Property
12/15/2009
3/23/2011
Inactive
Travelers Indemnity Company (The)
301855
Agent - Casualty
12/15/2009
1/12/2011
Inactive
Travelers Indemnity Company (The)
301855
Agent - Property
12/15/2009
1/12/2011
Inactive
Travelers Indemnity Company of America (The)
301093
Agent - Casualty
12/15/2009
3/23/2011
Inactive
Travelers Indemnity Company of America (The)
301093
Agent - Property
12/15/2009
3/23/2011
Inactive
Trumbull Insurance Company
300242
Agent - Casualty
10/26/2005
11/7/2008
Inactive
Trumbull Insurance Company
300242
Agent - Property
10/26/2005
11/7/2008
Inactive
UNUM Life Insurance Company of America
300817
Agent - Health
8/18/2008
10/1/2009
Inactive
UNUM Life Insurance Company of America
300817
Agent - Life
8/18/2008
10/1/2009
Inactive
United Financial Casualty Company
301886
Agent - Casualty
8/9/2006
2/18/2011
Inactive
United Financial Casualty Company
301886
Agent - Property
8/9/2006
2/18/2011
Inactive
WellCare Prescription Insurance Inc.
654329
Agent - Health
6/7/2010
2/14/2011
Inactive
West American Insurance Company
301112
Agent - Casualty
4/6/2011
3/31/2017
Inactive
West American Insurance Company
301112
Agent - Property
4/6/2011
3/31/2017
Inactive
Western National Life Insurance Company
300461
Agent - Life
12/6/2010
8/1/2011
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Blauvelt, Martha S
503052
Agent - Casualty
9/26/2005
12/31/2008
Inactive
Blauvelt, Martha S
503052
Agent - Property
9/26/2005
12/31/2008
Inactive
Knueven, Denise M
346146
Agent - Casualty
9/26/2005
3/31/2017
Inactive
Knueven, Denise M
346146
Agent - Property
9/26/2005
3/31/2017
Inactive
Miller, Beverly A
564261
Agent - Casualty
12/3/2009
12/19/2011
Inactive
Miller, Beverly A
564261
Agent - Health
12/4/2009
3/31/2017
Inactive
Miller, Beverly A
564261
Agent - Life
12/4/2009
10/15/2010
Inactive
Miller, Beverly A
564261
Agent - Property
12/3/2009
12/19/2011
Inactive
Pennington, Sarah F
675743
Agent - Health
1/22/2010
5/31/2011
Inactive
Pennington, Sarah F
675743
Agent - Life
1/22/2010
5/31/2011
Inactive
Samples, Brad W
594622
Agent - Casualty
9/26/2005
3/31/2017
Inactive
Samples, Brad W
594622
Agent - Property
9/26/2005
3/31/2017
Inactive
Vollmer, Jerry J
600890
Agent - Casualty
9/26/2005
3/31/2007
Inactive
Vollmer, Jerry J
600890
Agent - Health
9/26/2005
3/31/2007
Inactive
Vollmer, Jerry J
600890
Agent - Life
9/26/2005
3/31/2007
Inactive
Vollmer, Jerry J
600890
Agent - Property
9/26/2005
3/31/2007
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