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.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	09/15/2025	11/30/2025

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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	9/24/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/24/2024
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	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/24/2024
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
Active	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	8/9/2024
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
Active	Humana Medical Plan, Inc.	801568	Agent - Health	6/25/2025
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