DEPARTMENT OF INSURANCE

Affiliations

Name	Sursa, Adam Wade	DOIID	731966	NAIC NPN	2146461

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	4/4/2022		11/30/2025
Active	Non Resident	Agent	Life	4/4/2022		11/30/2025
Inactive	Non Resident	Agent	Property	7/9/2010	11/30/2011
Inactive	Non Resident	Agent	Casualty	7/9/2010	11/30/2011
* 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	Accendo Insurance Company	300312	Agent - Health	4/27/2022	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	4/27/2022
Active	Aetna Health Inc. (PA)	660717	Agent - Health	5/24/2022
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	4/27/2022
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	5/24/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	5/24/2022
Inactive	American Automobile Insurance Company	300953	Agent - Casualty	6/13/2011	7/7/2011
Inactive	American Automobile Insurance Company	300953	Agent - Property	6/13/2011	7/7/2011
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	11/22/2022
Active	Cincinnati Equitable Life Insurance Company	641870	Agent - Life	7/24/2023
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	4/27/2022
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	4/27/2022
Inactive	Fireman's Fund Insurance Company	301423	Agent - Casualty	10/20/2010	7/7/2011
Inactive	Fireman's Fund Insurance Company	301423	Agent - Property	10/20/2010	7/7/2011
Active	Humana Insurance Company	301104	Agent - Health	2/24/2023
Inactive	National Surety Corporation	300087	Agent - Casualty	6/13/2011	7/7/2011
Inactive	National Surety Corporation	300087	Agent - Property	6/13/2011	7/7/2011
Inactive	Pie Insurance Company (The)	300514	Agent - Casualty	6/13/2011	7/7/2011
Inactive	Pie Insurance Company (The)	300514	Agent - Property	6/13/2011	7/7/2011
Active	SilverScript Insurance Company	663526	Agent - Health	5/24/2022
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	11/22/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	11/22/2022	12/22/2022
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	11/22/2022
Inactive	WCF Select Insurance Company	301898	Agent - Casualty	6/13/2011	7/7/2011
Inactive	WCF Select Insurance Company	301898	Agent - Property	6/13/2011	7/7/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Arthur J Gallagher & Co Ins Brokers Of California Inc	513894	Agent - Property
Denied	Arthur J Gallagher & Co Ins Brokers Of California Inc	513894	Agent - Casualty
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Property	10/20/2010	12/6/2010
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Casualty	10/20/2010	12/6/2010