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DEPARTMENT OF INSURANCE
Affiliations
Name
Embroker Ins Services LLC
DOIID
901870
NAIC NPN
17701177
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Active
Non Resident
Agent
Casualty
12/15/2015
3/31/2027
Active
Non Resident
Agent
Property
12/15/2015
3/31/2027
Pending Replacement
Non Resident
Agent
Health
10/24/2016
3/31/2027
Pending Replacement
Non Resident
Agent
Life
10/24/2016
3/31/2027
Inactive
Non Resident
Surplus Lines Broker
Not Applicable
7/31/2017
8/1/2023
* 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
01/15/2025
03/31/2025
01/31/2025
01/31/2025
Yes
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Active
ACE American Insurance Company
300625
Agent - Casualty
2/8/2017
Active
ACE American Insurance Company
300625
Agent - Property
2/8/2017
Active
ACE Fire Underwriters Insurance Company
301679
Agent - Casualty
2/8/2017
Active
ACE Fire Underwriters Insurance Company
301679
Agent - Property
2/8/2017
Active
ACE Property and Casualty Insurance Company
300520
Agent - Casualty
2/8/2017
Active
ACE Property and Casualty Insurance Company
300520
Agent - Property
2/8/2017
Active
Allmerica Financial Alliance Insurance Company
300823
Agent - Casualty
7/11/2016
Active
Allmerica Financial Alliance Insurance Company
300823
Agent - Property
7/11/2016
Active
Allmerica Financial Benefit Insurance Company
301223
Agent - Casualty
7/11/2016
Active
Allmerica Financial Benefit Insurance Company
301223
Agent - Property
7/11/2016
Active
Arch Insurance Company
300688
Agent - Casualty
12/28/2017
Active
Arch Insurance Company
300688
Agent - Property
12/28/2017
Active
Berkley Insurance Company
301355
Agent - Casualty
8/8/2018
Inactive
Charter Oak Fire Insurance Company (The)
301501
Agent - Casualty
5/10/2016
11/30/2017
Inactive
Charter Oak Fire Insurance Company (The)
301501
Agent - Property
5/10/2016
11/30/2017
Active
Chubb National Insurance Company
301392
Agent - Casualty
2/8/2017
Active
Chubb National Insurance Company
301392
Agent - Property
2/8/2017
Active
Continental Casualty Company
301019
Agent - Casualty
12/16/2019
Active
Continental Casualty Company
301019
Agent - Property
12/16/2019
Inactive
Employers Assurance Company
300120
Agent - Casualty
7/7/2016
9/9/2022
Inactive
Employers Compensation Insurance Company
797885
Agent - Casualty
8/6/2018
9/9/2022
Inactive
Employers Preferred Insurance Company
520656
Agent - Casualty
7/7/2016
9/9/2022
Active
Everest National Insurance Company
301319
Agent - Casualty
9/26/2019
Active
Everest National Insurance Company
301319
Agent - Property
9/26/2019
Active
Executive Risk Indemnity Inc.
301510
Agent - Casualty
2/2/2018
Inactive
Farmington Casualty Company
301137
Agent - Casualty
5/10/2016
11/30/2017
Inactive
Farmington Casualty Company
301137
Agent - Property
5/10/2016
11/30/2017
Active
Federal Insurance Company
301144
Agent - Casualty
2/8/2017
Active
Federal Insurance Company
301144
Agent - Property
2/8/2017
Active
Fidelity and Guaranty Insurance Company
301009
Agent - Casualty
5/26/2022
Active
Fidelity and Guaranty Insurance Company
301009
Agent - Property
5/26/2022
Active
Great American Alliance Insurance Company
301247
Agent - Casualty
10/30/2019
Active
Great American Alliance Insurance Company
301247
Agent - Property
10/30/2019
Active
Great American Assurance Company
300327
Agent - Casualty
10/30/2019
Active
Great American Assurance Company
300327
Agent - Property
10/30/2019
Active
Great American Insurance Company
301586
Agent - Casualty
10/30/2019
Active
Great American Insurance Company
301586
Agent - Property
10/30/2019
Active
Great American Spirit Insurance Company
300233
Agent - Casualty
10/30/2019
Active
Great American Spirit Insurance Company
300233
Agent - Property
10/30/2019
Active
Great Northern Insurance Company
301107
Agent - Casualty
2/8/2017
Active
Great Northern Insurance Company
301107
Agent - Property
2/8/2017
Active
Greenwich Insurance Company
301754
Agent - Casualty
8/20/2019
Active
Greenwich Insurance Company
301754
Agent - Property
8/20/2019
Active
Hanover American Insurance Company (The)
300447
Agent - Casualty
7/11/2016
Active
Hanover American Insurance Company (The)
300447
Agent - Property
7/11/2016
Active
Hanover Insurance Company (The)
300508
Agent - Casualty
7/11/2016
Active
Hanover Insurance Company (The)
300508
Agent - Property
7/11/2016
Active
Hartford Accident and Indemnity Company
301917
Agent - Casualty
11/10/2021
Active
Hartford Accident and Indemnity Company
301917
Agent - Property
11/10/2021
Active
Hartford Insurance Company of the Southeast
1014204
Agent - Casualty
7/4/2021
Active
Hartford Insurance Company of the Southeast
1014204
Agent - Property
7/4/2021
Pending Replacement
Hartford Life and Accident Insurance Company
300878
Agent - Health
4/11/2017
Pending Replacement
Hartford Life and Accident Insurance Company
300878
Agent - Life
4/11/2017
Active
Hartford Underwriters Insurance Company
301064
Agent - Casualty
4/19/2021
Active
Hartford Underwriters Insurance Company
301064
Agent - Property
4/19/2021
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Health
2/14/2017
4/10/2018
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Life
2/14/2017
4/10/2018
Inactive
Kanawha Insurance Company
300127
Agent - Health
2/14/2017
12/8/2017
Inactive
Kanawha Insurance Company
300127
Agent - Life
2/14/2017
12/8/2017
Active
Massachusetts Bay Insurance Company
300898
Agent - Casualty
7/11/2016
Active
Massachusetts Bay Insurance Company
300898
Agent - Property
7/11/2016
Active
Midvale Indemnity Company
300292
Agent - Casualty
12/18/2017
Active
Midvale Indemnity Company
300292
Agent - Property
12/18/2017
Active
National Fire Insurance Company of Hartford
301063
Agent - Casualty
9/30/2024
Active
National Fire Insurance Company of Hartford
301063
Agent - Property
9/30/2024
Active
Pacific Indemnity Company
301610
Agent - Casualty
2/8/2017
Active
Pacific Indemnity Company
301610
Agent - Property
2/8/2017
Inactive
St. Paul Fire and Marine Insurance Company
300782
Agent - Casualty
12/7/2016
11/30/2017
Inactive
St. Paul Fire and Marine Insurance Company
300782
Agent - Property
12/7/2016
11/30/2017
Inactive
St. Paul Guardian Insurance Company
301372
Agent - Casualty
12/7/2016
11/30/2017
Inactive
St. Paul Guardian Insurance Company
301372
Agent - Property
12/7/2016
11/30/2017
Inactive
St. Paul Mercury Insurance Company
300783
Agent - Casualty
12/7/2016
11/30/2017
Inactive
St. Paul Mercury Insurance Company
300783
Agent - Property
12/7/2016
11/30/2017
Inactive
Standard Fire Insurance Company (The)
301068
Agent - Casualty
5/10/2016
11/30/2017
Inactive
Standard Fire Insurance Company (The)
301068
Agent - Property
5/10/2016
11/30/2017
Inactive
The Phoenix Insurance Company
301502
Agent - Casualty
5/10/2016
11/30/2017
Inactive
The Phoenix Insurance Company
301502
Agent - Property
5/10/2016
11/30/2017
Inactive
Travelers Casualty Insurance Company of America
300522
Agent - Casualty
5/10/2016
11/30/2017
Inactive
Travelers Casualty Insurance Company of America
300522
Agent - Property
5/10/2016
11/30/2017
Inactive
Travelers Casualty and Surety Company
301067
Agent - Casualty
5/10/2016
11/30/2017
Inactive
Travelers Casualty and Surety Company
301067
Agent - Property
5/10/2016
11/30/2017
Inactive
Travelers Casualty and Surety Company of America
301334
Agent - Casualty
12/24/2019
11/4/2022
Inactive
Travelers Casualty and Surety Company of America
301334
Agent - Property
12/24/2019
11/4/2022
Inactive
Travelers Indemnity Company (The)
301855
Agent - Casualty
5/10/2016
11/30/2017
Inactive
Travelers Indemnity Company (The)
301855
Agent - Property
5/10/2016
11/30/2017
Inactive
Travelers Indemnity Company of America (The)
301093
Agent - Casualty
5/10/2016
11/30/2017
Inactive
Travelers Indemnity Company of America (The)
301093
Agent - Property
5/10/2016
11/30/2017
Inactive
Travelers Indemnity Company of Connecticut (The)
301591
Agent - Casualty
5/10/2016
11/30/2017
Inactive
Travelers Indemnity Company of Connecticut (The)
301591
Agent - Property
5/10/2016
11/30/2017
Inactive
Travelers Property Casualty Company of America
301649
Agent - Casualty
5/10/2016
11/30/2017
Inactive
Travelers Property Casualty Company of America
301649
Agent - Property
5/10/2016
11/30/2017
Active
Twin City Fire Insurance Company
300721
Agent - Casualty
5/7/2017
Active
Twin City Fire Insurance Company
300721
Agent - Property
5/7/2017
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Health
10/20/2017
5/31/2023
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Life
10/20/2017
5/31/2023
Inactive
UnitedHealthcare of Kentucky, Ltd.
301337
Agent - Health
10/20/2017
5/31/2023
Inactive
UnitedHealthcare of Ohio, Inc.
300493
Agent - Health
9/1/2021
5/31/2023
Active
Valley Forge Insurance Company
301052
Agent - Casualty
12/16/2019
Active
Valley Forge Insurance Company
301052
Agent - Property
12/16/2019
Active
Vigilant Insurance Company
301143
Agent - Casualty
2/8/2017
Active
Vigilant Insurance Company
301143
Agent - Property
2/8/2017
Active
Westchester Fire Insurance Company
300990
Agent - Casualty
2/8/2017
Active
Westchester Fire Insurance Company
300990
Agent - Property
2/8/2017
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Denied
Derigiotis, David A
1248564
Agent - Casualty
Denied
Derigiotis, David A
1248564
Agent - Property
Inactive
Mangan, Thomas L
722099
Agent - Health
10/24/2016
12/31/2024
Inactive
Mangan, Thomas L
722099
Agent - Life
10/24/2016
12/31/2024
Inactive
Miller, Matthew Cowan
889698
Agent - Casualty
12/15/2015
10/4/2023
Inactive
Miller, Matthew Cowan
889698
Agent - Property
12/15/2015
10/4/2023
Inactive
Miller, Matthew Cowan
889698
Surplus Lines Broker - Not Applicable
7/31/2017
5/31/2023
Active
Noonan, Julie N
817360
Agent - Casualty
10/4/2022
Active
Noonan, Julie N
817360
Agent - Property
10/4/2022
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