DEPARTMENT OF INSURANCE

Affiliations

Name	Ross, Michael	DOIID	844129	NAIC NPN	17302580

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Administrator	Not Applicable	9/18/2017	1/31/2019
Inactive	Non Resident	Agent	Casualty	9/26/2014	1/31/2019
Inactive	Non Resident	Agent	Health	12/22/2021	1/31/2023
Inactive	Non Resident	Agent	Life	6/27/2014	1/31/2019
Inactive	Non Resident	Agent	Property	9/26/2014	1/31/2019
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	2/25/2015	8/4/2015
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	2/25/2015	8/4/2015
Inactive	American General Life Insurance Company	301585	Agent - Health	2/19/2015	8/22/2016
Inactive	American General Life Insurance Company	301585	Agent - Life	2/19/2015	8/22/2016
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	4/13/2015	7/25/2017
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	4/13/2015	7/25/2017
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	3/9/2015	8/3/2015
Inactive	American Modern Select Insurance Company	581481	Agent - Property	3/9/2015	8/3/2015
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	3/9/2015	8/3/2015
Inactive	American Southern Home Insurance Company	626276	Agent - Property	3/9/2015	8/3/2015
Inactive	Berkley Insurance Company	301355	Agent - Casualty	3/16/2015	8/24/2016
Inactive	Carolina Casualty Insurance Company	300271	Agent - Casualty	3/16/2015	8/24/2016
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	2/19/2015	3/14/2019
Inactive	Continental General Insurance Company	300691	Agent - Health	8/9/2018	1/25/2019
Inactive	Continental General Insurance Company	300691	Agent - Life	8/9/2018	1/25/2019
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	2/19/2015	1/31/2019
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	5/27/2015	1/31/2019
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	5/27/2015	1/31/2019
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Casualty	3/3/2015	9/23/2016
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Health	3/3/2015	1/31/2019
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Property	3/3/2015	9/23/2016
Inactive	Granite State Insurance Company	300818	Agent - Casualty	2/24/2015	1/31/2019
Inactive	Granite State Insurance Company	300818	Agent - Health	2/24/2015	1/31/2019
Inactive	Granite State Insurance Company	300818	Agent - Property	2/24/2015	1/31/2019
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	2/26/2015	3/4/2019
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	2/26/2015	3/4/2019
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	2/19/2015	1/31/2019
Inactive	Humana Insurance Company	301104	Agent - Health	2/19/2015	1/31/2019
Inactive	Humana Insurance Company	301104	Agent - Life	2/19/2015	1/31/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	2/19/2015	1/31/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	2/19/2015	1/31/2019
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	2/24/2015	1/31/2019
Inactive	Illinois National Insurance Company	301367	Agent - Health	2/24/2015	1/31/2019
Inactive	Illinois National Insurance Company	301367	Agent - Property	2/24/2015	1/31/2019
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/19/2015	8/9/2018
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/19/2015	8/9/2018
Inactive	LM General Insurance Company	300133	Agent - Casualty	3/3/2015	9/23/2016
Inactive	LM General Insurance Company	300133	Agent - Property	3/3/2015	9/23/2016
Inactive	LM Insurance Corporation	301061	Agent - Casualty	3/3/2015	9/23/2016
Inactive	LM Insurance Corporation	301061	Agent - Property	3/3/2015	9/23/2016
Inactive	Liberty Insurance Corporation	300444	Agent - Casualty	3/3/2015	9/23/2016
Inactive	Liberty Insurance Corporation	300444	Agent - Health	3/3/2015	1/31/2019
Inactive	Liberty Insurance Corporation	300444	Agent - Property	3/3/2015	9/23/2016
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	3/3/2015	9/23/2016
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Property	3/3/2015	9/23/2016
Inactive	Liberty Mutual Insurance Company	301159	Agent - Casualty	3/3/2015	9/23/2016
Inactive	Liberty Mutual Insurance Company	301159	Agent - Property	3/3/2015	9/23/2016
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	3/5/2015	1/31/2019
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	3/5/2015	1/31/2019
Inactive	National Casualty Company	301483	Agent - Casualty	3/10/2015	6/24/2015
Inactive	National Casualty Company	301483	Agent - Property	3/10/2015	6/24/2015
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	2/24/2015	1/31/2019
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	2/24/2015	1/31/2019
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	2/24/2015	1/31/2019
Inactive	New Hampshire Insurance Company	301670	Agent - Casualty	2/24/2015	1/31/2019
Inactive	New Hampshire Insurance Company	301670	Agent - Health	2/24/2015	1/31/2019
Inactive	New Hampshire Insurance Company	301670	Agent - Property	2/24/2015	1/31/2019
Inactive	New York Life Insurance Company	300431	Agent - Health	8/15/2014	7/13/2015
Inactive	New York Life Insurance Company	300431	Agent - Life	8/15/2014	7/13/2015
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	7/18/2017	11/19/2018
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	3/6/2015	1/31/2019
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	3/6/2015	1/31/2019
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	4/10/2015	7/31/2015
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	4/10/2015	7/31/2015
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	4/10/2015	7/31/2015
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	4/10/2015	7/31/2015
Inactive	Trustmark Insurance Company	300317	Agent - Health	2/14/2015	3/3/2018
Inactive	Trustmark Insurance Company	300317	Agent - Life	2/14/2015	3/3/2018
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	3/6/2015	1/31/2019
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	3/6/2015	1/31/2019
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	2/19/2015	8/22/2016
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	2/19/2015	8/22/2016
Inactive	Unitrin Direct Property & Casualty Company	637443	Agent - Casualty	12/10/2014	7/6/2015
Inactive	Unitrin Direct Property & Casualty Company	637443	Agent - Property	12/10/2014	7/6/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bestow Agency LLC	949030	Agent - Health	3/25/2017	11/27/2018
Inactive	Bestow Agency LLC	949030	Agent - Life	3/25/2017	11/27/2018
Inactive	Bestow Agency LLC	949030	Administrator - Not Applicable	11/13/2017	11/27/2018
Inactive	DVM Insurance Agency	636779	Agent - Casualty	3/10/2015	6/24/2015
Inactive	DVM Insurance Agency	636779	Agent - Property	3/10/2015	6/24/2015
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Health	12/15/2014	7/13/2015
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Life	12/15/2014	7/13/2015
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Casualty	12/15/2014	7/13/2015
Inactive	Mercer Health & Benefits Administration LLC	656414	Agent - Property	12/15/2014	7/13/2015