DEPARTMENT OF INSURANCE

Affiliations

Name	Plansource Benefits Administration, Inc. DBA : PlanSource Holdings, Inc.	DOIID	708356	NAIC NPN	11123024

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	2/22/2022	3/31/2027
Active	Non Resident	Agent	Property	11/14/2024	3/31/2027
Active	Non Resident	Agent	Health	4/25/2013	3/31/2027
Active	Non Resident	Agent	Casualty	11/14/2024	3/31/2027
Active	Non Resident	Agent	Life	4/25/2013	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
Administrator	01/15/2025	03/31/2025	01/24/2025	01/24/2025	Yes
Agent	01/15/2025	03/31/2025	02/07/2025	02/07/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	6/15/2015
Active	Aetna Life Insurance Company	301140	Agent - Health	6/15/2015
Active	Aetna Life Insurance Company	301140	Agent - Life	6/15/2015
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	12/15/2016	10/5/2021
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	12/15/2016	10/5/2021
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	5/29/2024
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	5/29/2024
Active	Metropolitan Life Insurance Company	301948	Agent - Health	11/16/2016
Active	Metropolitan Life Insurance Company	301948	Agent - Life	11/16/2016
Active	Provident Life and Accident Insurance Company	301525	Agent - Health	10/28/2015
Active	Provident Life and Accident Insurance Company	301525	Agent - Life	10/28/2015
Active	Standard Insurance Company	300185	Agent - Health	12/17/2013
Active	Standard Insurance Company	300185	Agent - Life	12/17/2013
Active	Starmount Life Insurance Company	628031	Agent - Health	10/8/2021
Active	Sun Life Assurance Company of Canada	301811	Agent - Health	10/30/2014
Active	Sun Life Assurance Company of Canada	301811	Agent - Life	10/30/2014
Active	UNUM Life Insurance Company of America	300817	Agent - Health	10/28/2015
Active	UNUM Life Insurance Company of America	300817	Agent - Life	10/28/2015
Active	Unum Insurance Company	301499	Agent - Health	10/8/2021
Active	Unum Insurance Company	301499	Agent - Life	10/8/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Goin, Bruce Robert	687303	Agent - Health	6/25/2009	6/13/2012
Inactive	Goin, Bruce Robert	687303	Agent - Life	6/25/2009	6/13/2012
Active	Johnson, Joshua Jerome	797029	Administrator - Not Applicable	9/13/2024
Active	Johnson, Joshua Jerome	797029	Agent - Casualty	11/14/2024
Active	Johnson, Joshua Jerome	797029	Agent - Health	8/21/2024
Active	Johnson, Joshua Jerome	797029	Agent - Life	8/21/2024
Active	Johnson, Joshua Jerome	797029	Agent - Property	11/14/2024
Denied	Linusson, Lauren Marie	781205	Agent - Health
Denied	Linusson, Lauren Marie	781205	Agent - Life
Inactive	Messal, Anita Marie Quamme	600363	Administrator - Not Applicable	6/15/2017	9/30/2021
Inactive	Messal, Anita Marie Quamme	600363	Agent - Health	4/25/2013	9/30/2021
Inactive	Messal, Anita Marie Quamme	600363	Agent - Life	4/25/2013	9/30/2021
Inactive	Taylor, Bradley J	598967	Administrator - Not Applicable	2/22/2022	8/21/2024
Inactive	Taylor, Bradley J	598967	Agent - Health	4/8/2020	8/21/2024
Inactive	Taylor, Bradley J	598967	Agent - Life	4/8/2020	8/21/2024