DEPARTMENT OF INSURANCE
Affiliations
NameBalsom, Michael DOIID814127NAIC NPN16820997
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentVariable Life and Variable Annuities7/9/2013 8/31/2024
ActiveNon ResidentAgentHealth7/9/2013 8/31/2024
ActiveNon ResidentAgentLife7/9/2013 8/31/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent06/15/202408/31/2024   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAllianz Life Insurance Company of North America301791Agent - Life2/17/2021 
ActiveAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities2/17/2021 
ActiveBanner Life Insurance Company301696Agent - Life5/3/2019 
ActiveBrighthouse Life Insurance Company301829Agent - Health5/7/2019 
ActiveBrighthouse Life Insurance Company301829Agent - Life5/3/2019 
ActiveBrighthouse Life Insurance Company301829Agent - Variable Life and Variable Annuities5/7/2019 
InactiveEquitable Financial Life Insurance Company of America301772Agent - Life5/22/20223/22/2023
InactiveEquitable Financial Life Insurance Company of America301772Agent - Variable Life and Variable Annuities5/22/20223/22/2023
ActiveForethought Life Insurance Company301407Agent - Health4/27/2019 
ActiveForethought Life Insurance Company301407Agent - Life4/27/2019 
ActiveForethought Life Insurance Company301407Agent - Variable Life and Variable Annuities4/27/2019 
ActiveJackson National Life Insurance Company300486Agent - Life5/16/2019 
ActiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities5/16/2019 
InactiveLincoln National Life Insurance Company (The)301382Agent - Health7/9/201310/17/2018
ActiveLincoln National Life Insurance Company (The)301382Agent - Life2/10/2020 
ActiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities2/10/2020 
ActiveNationwide Life Insurance Company300495Agent - Health7/11/2019 
ActiveNationwide Life Insurance Company300495Agent - Life7/11/2019 
ActiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities7/11/2019 
ActivePacific Life Insurance Company301848Agent - Health7/25/2019 
ActivePacific Life Insurance Company301848Agent - Life7/25/2019 
ActivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities7/25/2019 
ActivePrincipal Life Insurance Company300129Agent - Health5/13/2019 
ActivePrincipal Life Insurance Company300129Agent - Life5/13/2019 
ActivePrincipal Life Insurance Company300129Agent - Variable Life and Variable Annuities5/13/2019 
ActivePrincipal National Life Insurance Company301926Agent - Health5/13/2019 
ActivePrincipal National Life Insurance Company301926Agent - Life5/13/2019 
ActivePrincipal National Life Insurance Company301926Agent - Variable Life and Variable Annuities5/13/2019 
InactivePruco Life Insurance Company300954Agent - Life5/7/201912/21/2022
InactivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities5/7/201912/21/2022
ActiveTransamerica Life Insurance Company300571Agent - Life10/7/2013 
ActiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities10/7/2013 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveMerrill Lynch Life Agency Inc.400527Agent - Life7/16/20135/2/2019
InactiveMerrill Lynch Life Agency Inc.400527Agent - Variable Life and Variable Annuities7/16/20135/2/2019
InactiveMerrill Lynch Life Agency Inc.400527Agent - Health7/16/201310/17/2018
ActiveMorgan Stanley Insurance Services Inc644934Agent - Life5/1/2019 
ActiveMorgan Stanley Insurance Services Inc644934Agent - Variable Life and Variable Annuities5/1/2019 
ActiveMorgan Stanley Insurance Services Inc644934Agent - Health5/7/2019 

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