DEPARTMENT OF INSURANCE

Affiliations

Name	Platinum Ins Agency	DOIID	876518	NAIC NPN	17572833

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Property	4/29/2015	11/1/2017
Inactive	Resident	Agent	Casualty	4/29/2015	11/1/2017
Inactive	Resident	Agent	Health	7/8/2015	11/1/2017
Inactive	Resident	Agent	Life	4/29/2015	11/1/2017
* 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	5 Star Life Insurance Company	300673	Agent - Health	11/24/2015	11/1/2017
Inactive	5 Star Life Insurance Company	300673	Agent - Life	11/24/2015	11/1/2017
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	7/20/2015	11/1/2017
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	7/20/2015	11/1/2017
Inactive	American Retirement Life Insurance Company	706303	Agent - Health	3/9/2016	11/1/2017
Inactive	American Retirement Life Insurance Company	706303	Agent - Life	3/9/2016	11/1/2017
Inactive	Americo Financial Life and Annuity Insurance Company	300869	Agent - Life	9/8/2015	10/10/2017
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	7/29/2015	11/1/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Health	7/29/2015	11/1/2017
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/29/2015	11/1/2017
Inactive	Assurity Life Insurance Company	301099	Agent - Health	8/17/2015	11/27/2017
Inactive	Assurity Life Insurance Company	301099	Agent - Life	8/17/2015	11/27/2017
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Health	3/14/2016	11/1/2017
Inactive	Bankers Fidelity Assurance Company	554627	Agent - Life	3/14/2016	11/1/2017
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Health	3/14/2016	11/1/2017
Inactive	Bankers Fidelity Life Insurance Company	300193	Agent - Life	3/14/2016	11/1/2017
Inactive	Banner Life Insurance Company	301696	Agent - Life	7/13/2015	11/1/2017
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	1/5/2017	11/1/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	1/5/2017	11/1/2017
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Health	8/18/2017	11/1/2017
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Life	8/18/2017	11/1/2017
Inactive	Combined Insurance Company of America	301472	Agent - Health	7/14/2015	11/1/2017
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/5/2017	11/1/2017
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/5/2017	11/1/2017
Inactive	Gerber Life Insurance Company	300529	Agent - Health	9/9/2015	11/1/2017
Inactive	Gerber Life Insurance Company	300529	Agent - Life	9/9/2015	11/1/2017
Inactive	Great Western Insurance Company	501693	Agent - Life	1/13/2016	11/1/2017
Inactive	Medico Corp Life Insurance Company	301777	Agent - Health	3/22/2016	12/21/2016
Inactive	Medico Corp Life Insurance Company	301777	Agent - Life	3/22/2016	12/21/2016
Inactive	Medico Insurance Company	301559	Agent - Health	3/22/2016	12/21/2016
Inactive	Medico Insurance Company	301559	Agent - Life	3/22/2016	12/21/2016
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	6/9/2015	7/31/2017
Inactive	Principal National Life Insurance Company	301926	Agent - Life	7/14/2015	11/1/2017
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	6/1/2015	11/1/2017
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	6/1/2015	11/1/2017
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	12/28/2015	11/1/2017
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	12/28/2015	11/1/2017
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	1/6/2017	11/1/2017
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	1/6/2017	11/1/2017
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	1/6/2017	11/1/2017
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	1/6/2017	11/1/2017
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	10/14/2015	2/15/2017
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	10/14/2015	2/15/2017
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	12/28/2015	11/1/2017
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	12/28/2015	11/1/2017
Inactive	United Financial Casualty Company	301886	Agent - Casualty	6/1/2015	11/1/2017
Inactive	United Financial Casualty Company	301886	Agent - Property	6/1/2015	11/1/2017

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arthur, Micah Shawn	577683	Agent - Casualty	4/29/2015	9/1/2017
Inactive	Arthur, Micah Shawn	577683	Agent - Health	7/8/2015	9/1/2017
Inactive	Arthur, Micah Shawn	577683	Agent - Life	4/29/2015	9/1/2017
Inactive	Arthur, Micah Shawn	577683	Agent - Property	4/29/2015	9/1/2017