DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	US Administrator Claims LLC	DOIID	744512	NAIC NPN	12919759

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	6/24/2022		3/31/2025
Active	Non Resident	Independent Adjuster	Property & Casualty	1/24/2011		3/31/2025
* 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
Independent Adjuster	01/15/2025	03/31/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Chapman, Jessica Lynn	1025342	Independent Adjuster - Workers' Compensation	2/17/2023
Active	Goff, Michael Lee	317192	Administrator - Not Applicable	6/27/2022
Inactive	Greenwood, Sandra	621066	Independent Adjuster - Workers' Compensation	1/24/2011	5/20/2019
Active	Helton, Jana Lee	852409	Independent Adjuster - Workers' Compensation	10/31/2018