DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Riverside Demand Services, LLC	DOIID	958710	NAIC NPN	18383316

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	5/29/2019		3/31/2025
Active	Non Resident	Agent	Health	5/29/2019		3/31/2025
* 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

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	6/10/2019
Active	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	6/10/2019
Inactive	American National Insurance Company	301861	Agent - Health	8/3/2017	2/14/2019
Inactive	American National Insurance Company	301861	Agent - Life	8/3/2017	2/14/2019
Active	Gerber Life Insurance Company	300529	Agent - Health	7/16/2019
Active	Gerber Life Insurance Company	300529	Agent - Life	7/16/2019

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Reboin, James Michael	836052	Agent - Health	6/27/2017	1/31/2019
Inactive	Reboin, James Michael	836052	Agent - Life	6/27/2017	1/31/2019
Active	Skoda, Bradley	1023457	Agent - Health	5/29/2019
Active	Skoda, Bradley	1023457	Agent - Life	5/29/2019