DEPARTMENT OF INSURANCE
Affiliations
NameBurgess, Amy DOIID824565NAIC NPN7479080
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
Pending ReplacementNon ResidentAgentLife10/16/2013 6/30/2024
Pending ReplacementNon ResidentAgentHealth10/16/2013 6/30/2024
Pending ReplacementNon ResidentAgentProperty10/10/2014 6/30/2024
Pending ReplacementNon ResidentAgentCasualty10/10/2014 6/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent04/15/202406/30/2024   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveContinental American Insurance Company301700Agent - Health10/28/20136/16/2016
InactiveContinental American Insurance Company301700Agent - Life10/28/20136/16/2016
Pending ReplacementNational Casualty Company301483Agent - Casualty11/4/2014 
Pending ReplacementNational Casualty Company301483Agent - Property11/4/2014 
InactiveProvident Life and Accident Insurance Company301525Agent - Health11/6/20143/12/2016
InactiveProvident Life and Accident Insurance Company301525Agent - Life11/6/20143/12/2016
InactiveReliaStar Life Insurance Company301712Agent - Health8/27/201412/18/2020
InactiveReliaStar Life Insurance Company301712Agent - Life8/27/201412/18/2020
InactiveUNUM Life Insurance Company of America300817Agent - Health11/6/20143/12/2016
InactiveUNUM Life Insurance Company of America300817Agent - Life11/6/20143/12/2016
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
PendingAptia Insurance Services Group LLC1283785Agent - Health  
PendingAptia Insurance Services Group LLC1283785Agent - Life  
Pending ReplacementDVM Insurance Agency636779Agent - Casualty11/5/2014 
Pending ReplacementDVM Insurance Agency636779Agent - Property11/5/2014 
InactiveMercer Health & Benefits Administration LLC656414Agent - Health1/15/201912/18/2020
InactiveMercer Health & Benefits Administration LLC656414Agent - Life1/15/201912/18/2020
Pending ReplacementMercer Health & Benefits Administration LLC656414Agent - Casualty1/15/2019 
Pending ReplacementMercer Health & Benefits Administration LLC656414Agent - Property1/15/2019 

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