DEPARTMENT OF INSURANCE

Affiliations

Name	Assured Nl Ins Services Inc DBA : Risk Management Service Company	DOIID	769431	NAIC NPN	16363684

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Administrator	Not Applicable	10/31/2017	8/28/2024
Active	Resident	Agent	Property	1/15/2024		3/31/2027
Active	Resident	Agent	Life	6/20/2012		3/31/2027
Active	Resident	Agent	Health	6/20/2012		3/31/2027
Active	Resident	Agent	Casualty	1/15/2024		3/31/2027
Active	Resident	Independent Adjuster	Property & Casualty	2/27/2012		3/31/2027
Denied	Non Resident	Independent Adjuster	Crop
Denied	Non Resident	Independent Adjuster	Workers' Compensation
* 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	01/15/2025	03/31/2025	01/16/2025	01/16/2025	Yes
Independent Adjuster	01/15/2025	03/31/2025	01/16/2025	01/16/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American General Life Insurance Company	301585	Agent - Health	2/1/2017	1/17/2018
Inactive	American General Life Insurance Company	301585	Agent - Life	2/1/2017	1/17/2018
Active	American Heritage Life Insurance Company	300272	Agent - Health	5/29/2017
Active	American Heritage Life Insurance Company	300272	Agent - Life	5/29/2017
Active	Berkshire Life Insurance Company of America	300983	Agent - Health	4/28/2018
Active	Berkshire Life Insurance Company of America	300983	Agent - Life	4/28/2018
Active	Bridgefield Casualty Insurance Company	500013	Agent - Casualty	1/17/2024
Active	Guardian Life Insurance Company of America	301316	Agent - Health	4/28/2018
Active	Guardian Life Insurance Company of America	301316	Agent - Life	4/28/2018

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Anderson, Eric Earl	311358	Agent - Health	11/17/2016	9/7/2022
Inactive	Anderson, Eric Earl	311358	Agent - Life	11/17/2016	9/7/2022
Denied	Belanger, Roberta Ann	683434	Independent Adjuster - Workers' Compensation
Inactive	Bozarth, Jonathan E	1208610	Agent - Health	9/16/2022	3/29/2024
Denied	Bozarth, Jonathan E	1208610	Agent - Life
Active	Cook, Brooke Elizabeth	302432	Independent Adjuster - Property & Casualty	12/29/2014
Inactive	Funkhouser, Marlene Deanne	353676	Independent Adjuster - Property & Casualty	2/9/2015	11/17/2016
Inactive	Gardner, Paula J	307461	Independent Adjuster - Property & Casualty	2/27/2012	11/17/2016
Active	Greenwell, Meghan E	797030	Independent Adjuster - Property & Casualty	2/9/2015
Denied	Haga, Seth	1251792	Agent - Casualty
Active	Haga, Seth	1251792	Agent - Health	2/20/2024
Active	Haga, Seth	1251792	Agent - Life	2/20/2024
Denied	Haga, Seth	1251792	Agent - Property
Active	Hagan, Kelly Drury	337003	Administrator - Not Applicable	10/31/2017
Active	Hagan, Kelly Drury	337003	Agent - Health	9/19/2017
Active	Hagan, Kelly Drury	337003	Agent - Life	9/19/2017
Inactive	Head, Jeremy Michael	583602	Independent Adjuster - Property & Casualty	2/9/2015	12/31/2020
Inactive	Heiser, Scott R	385313	Agent - Health	6/20/2012	9/7/2022
Inactive	Heiser, Scott R	385313	Agent - Life	6/20/2012	9/7/2022
Active	Houston, Debra E	389774	Independent Adjuster - Property & Casualty	2/9/2015
Active	Mattingly, Joseph Harold	309176	Independent Adjuster - Property & Casualty	2/27/2012
Active	McAlister, Kimberly Nunn	363873	Independent Adjuster - Property & Casualty	2/9/2015
Inactive	McCulloch, James Clarke	550243	Independent Adjuster - Property & Casualty	2/9/2015	3/29/2024
Inactive	Miller, Sarah	659932	Independent Adjuster - Property & Casualty	2/9/2015	2/1/2019
Inactive	Musselman, Elaine Mary	341410	Agent - Health	10/16/2017	9/30/2021
Inactive	Musselman, Elaine Mary	341410	Agent - Life	10/16/2017	9/30/2021
Inactive	Prisco, David J	616562	Independent Adjuster - Property & Casualty	2/9/2015	4/11/2022
Active	Reid, Jennifer Lynn	319876	Independent Adjuster - Property & Casualty	10/30/2013
Active	Rigdon, Lori Jane	550240	Independent Adjuster - Property & Casualty	2/9/2015
Inactive	Rusche, Melanie Elizabeth	731908	Independent Adjuster - Property & Casualty	2/9/2015	1/12/2016
Inactive	Rusche, Teresa Gail	550242	Independent Adjuster - Property & Casualty	2/27/2012	9/7/2022
Active	Valenzuela, Hannah Paige	757986	Independent Adjuster - Property & Casualty	2/9/2015
Active	Welch, Christopher J	502399	Independent Adjuster - Property & Casualty	2/9/2015
Inactive	West, Gary Elwood	559185	Independent Adjuster - Property & Casualty	2/27/2012	9/7/2022
Active	Witte, David Anthony	513678	Agent - Casualty	1/15/2024
Active	Witte, David Anthony	513678	Agent - Property	1/15/2024