DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Brokers Insurance Corporation	DOIID	625319	NAIC NPN	2109675

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	3/27/2006	3/31/2014
Inactive	Non Resident	Agent	Health	3/27/2006	3/31/2014
* 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	Columbus Life Insurance Company	301227	Agent - Health	11/24/2008	6/21/2012
Inactive	Columbus Life Insurance Company	301227	Agent - Life	11/24/2008	6/21/2012
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Health	10/14/2011	3/31/2014
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	10/14/2011	3/31/2014
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	9/19/2009	3/31/2014
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	9/19/2009	3/31/2014
Inactive	Independent Order of Foresters	300743	Agent - Life	12/11/2009	2/4/2011
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	12/16/2009	4/14/2014
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	12/16/2009	4/14/2014

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Meyer, Robert J	557831	Agent - Health	3/27/2006	3/31/2014
Inactive	Meyer, Robert J	557831	Agent - Life	3/27/2006	3/31/2014