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DEPARTMENT OF INSURANCE
Affiliations
Name
Bass, Mouzon
DOIID
741424
NAIC NPN
1091341
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Active
Non Resident
Administrator
Not Applicable
2/10/2021
9/30/2025
Active
Non Resident
Agent
Life
11/27/2019
9/30/2025
Active
Non Resident
Agent
Health
11/27/2019
9/30/2025
* 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
Arch Insurance Company
300688
Agent - Health
4/18/2012
6/21/2012
Inactive
Berkshire Life Insurance Company of America
300983
Agent - Health
8/12/2011
10/10/2015
Inactive
Berkshire Life Insurance Company of America
300983
Agent - Life
8/12/2011
10/10/2015
Inactive
Fidelity Security Life Insurance Company
300466
Agent - Health
1/8/2020
6/25/2024
Inactive
Fidelity Security Life Insurance Company
300466
Agent - Life
1/8/2020
6/25/2024
Inactive
Guardian Insurance & Annuity Company Inc. (The)
301920
Agent - Life
8/12/2011
10/10/2015
Inactive
Guardian Life Insurance Company of America
301316
Agent - Health
8/12/2011
10/10/2015
Inactive
Guardian Life Insurance Company of America
301316
Agent - Life
8/12/2011
10/10/2015
Active
Mutual of Omaha Insurance Company
301012
Agent - Health
1/15/2020
Active
United World Life Insurance Company
300532
Agent - Health
1/15/2020
Active
United of Omaha Life Insurance Company
300156
Agent - Health
1/15/2020
Active
United of Omaha Life Insurance Company
300156
Agent - Life
1/15/2020
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Ebenconcepts Co
955223
Agent - Life
6/1/2020
2/16/2024
Inactive
Ebenconcepts Co
955223
Agent - Health
6/1/2020
2/16/2024
Active
Employers Direct Health Inc
744503
Administrator - Not Applicable
2/12/2021
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