DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Choice Administrators Ins Services Inc	DOIID	751630	NAIC NPN	2750567

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	4/6/2011	6/18/2015
Inactive	Non Resident	Agent	Life	9/19/2011	6/18/2015
Inactive	Non Resident	Agent	Health	9/19/2011	6/18/2015
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Brown, Edward James	713868	Agent - Health	9/19/2011	6/18/2015
Inactive	Brown, Edward James	713868	Agent - Life	9/19/2011	6/18/2015
Inactive	Word, John Marion	572226	Administrator - Not Applicable	4/6/2011	7/20/2016