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DEPARTMENT OF INSURANCE
Affiliations
Name
United Capital Risk Management LLC
DOIID
739083
NAIC NPN
15907756
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Non Resident
Agent
Health
2/13/2024
3/31/2024
Inactive
Non Resident
Agent
Life
2/13/2024
3/31/2024
* 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
Aetna Health and Life Insurance Company
300523
Agent - Health
7/3/2018
1/3/2024
Inactive
Allianz Life Insurance Company of North America
301791
Agent - Life
3/7/2019
1/3/2024
Inactive
American Continental Insurance Company
643130
Agent - Life
7/3/2018
8/11/2021
Inactive
Banner Life Insurance Company
301696
Agent - Life
5/12/2016
1/3/2024
Inactive
Continental Life Insurance Company of Brentwood Tennessee
301526
Agent - Health
7/3/2018
1/3/2024
Inactive
Midland National Life Insurance Company
300923
Agent - Life
12/7/2016
1/3/2024
Inactive
Pruco Life Insurance Company
300954
Agent - Life
2/15/2024
3/31/2024
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Backora, Richard William
837912
Agent - Health
4/30/2016
2/13/2017
Inactive
Backora, Richard William
837912
Agent - Life
4/30/2016
2/13/2017
Inactive
Cass, David M
562627
Agent - Health
1/16/2020
4/27/2022
Inactive
Cass, David M
562627
Agent - Life
1/16/2020
4/27/2022
Inactive
Fritz, Robert F
1221260
Agent - Health
10/12/2022
1/3/2024
Inactive
Fritz, Robert F
1221260
Agent - Life
10/12/2022
1/3/2024
Inactive
Kelly, Heather Lynn
900397
Agent - Health
2/15/2017
1/16/2020
Inactive
Kelly, Heather Lynn
900397
Agent - Life
2/15/2017
1/16/2020
Denied
Latini, Gregory
905282
Agent - Health
Denied
Latini, Gregory
905282
Agent - Life
Denied
Mcdonald, Thomas K
960371
Agent - Health
Denied
Mcdonald, Thomas K
960371
Agent - Life
Inactive
Rivers, James Francis
1304398
Agent - Health
2/13/2024
3/31/2024
Inactive
Rivers, James Francis
1304398
Agent - Life
2/13/2024
3/31/2024
Denied
Roller, Ryan
1026327
Agent - Health
Inactive
Roller, Ryan
1026327
Agent - Life
2/12/2019
12/20/2023
Inactive
Slafsky, Neal Aaron
736924
Agent - Health
10/7/2010
4/21/2014
Inactive
Slafsky, Neal Aaron
736924
Agent - Life
10/7/2010
4/21/2014
Inactive
Snyder, Christian
1116326
Agent - Health
4/1/2022
1/11/2023
Inactive
Snyder, Christian
1116326
Agent - Life
4/1/2022
1/11/2023
Inactive
Surenkamp, Raymond Michael
565337
Agent - Life
5/2/2018
12/20/2021
Denied
Weatherly, Brian Robert
1028880
Agent - Health
Denied
Weatherly, Brian Robert
1028880
Agent - Life
Denied
Wolfe, Robert Brian
749436
Agent - Health
Denied
Wolfe, Robert Brian
749436
Agent - Life
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