DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Petpremium Inc	DOIID	818198	NAIC NPN	17028173

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	8/22/2013		3/31/2027
Active	Non Resident	Agent	Property	8/22/2013		3/31/2027
* 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	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Modern Home Insurance Company	300791	Agent - Casualty	9/15/2021
Active	American Modern Home Insurance Company	300791	Agent - Property	9/15/2021
Inactive	American Pet Insurance Company, Inc.	301240	Agent - Casualty	8/26/2022	8/5/2025
Inactive	American Pet Insurance Company, Inc.	301240	Agent - Property	8/26/2022	8/5/2025
Active	Independence American Insurance Company	524747	Agent - Casualty	6/15/2022
Active	Independence American Insurance Company	524747	Agent - Property	1/22/2021
Active	United States Fire Insurance Company	582240	Agent - Casualty	11/16/2021
Active	United States Fire Insurance Company	582240	Agent - Property	11/16/2021
Active	XL Specialty Insurance Company	301605	Agent - Casualty	11/16/2021
Active	XL Specialty Insurance Company	301605	Agent - Property	11/16/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Boucher, Sandra M	732231	Agent - Casualty	8/22/2013	9/10/2014
Inactive	Boucher, Sandra M	732231	Agent - Property	8/22/2013	9/10/2014
Inactive	Levin, Robert D	1077635	Agent - Casualty	3/19/2020	9/30/2024
Inactive	Levin, Robert D	1077635	Agent - Property	3/19/2020	9/30/2024
Active	Navarro, Edward Gregory	1343778	Agent - Casualty	7/16/2024
Active	Navarro, Edward Gregory	1343778	Agent - Property	7/16/2024
Inactive	Rozenberg, Jeroen George	847614	Agent - Casualty	9/10/2014	3/19/2020
Inactive	Rozenberg, Jeroen George	847614	Agent - Property	9/10/2014	3/19/2020