DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ross, Michael Robert	DOIID	968813	NAIC NPN	8102987

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	6/26/2024		1/31/2025
Active	Non Resident	Agent	Property	6/26/2024		1/31/2025
Active	Non Resident	Agent	Life	6/26/2024		1/31/2025
Active	Non Resident	Agent	Health	6/26/2024		1/31/2025
* 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	11/15/2024	01/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Berkley Regional Insurance Company	300920	Agent - Casualty	1/20/2022	3/18/2024
Inactive	Berkley Regional Insurance Company	300920	Agent - Property	1/20/2022	3/18/2024
Inactive	Independence American Insurance Company	524747	Agent - Casualty	8/24/2023	3/18/2024
Inactive	Independence American Insurance Company	524747	Agent - Property	8/24/2023	3/18/2024
Inactive	Manufacturers Alliance Insurance Company	519940	Agent - Casualty	2/14/2023	3/18/2024
Inactive	Manufacturers Alliance Insurance Company	519940	Agent - Property	2/14/2023	3/18/2024
Inactive	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Casualty	2/14/2023	3/18/2024
Inactive	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Property	2/14/2023	3/18/2024
Inactive	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Casualty	2/14/2023	3/18/2024
Inactive	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Property	2/14/2023	3/18/2024
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Casualty	4/20/2023	2/26/2024
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Property	4/20/2023	2/26/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	5/29/2019	4/3/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	5/29/2019	4/3/2023
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	5/29/2019	4/3/2023
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/29/2019	4/3/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AssuredPartners New England Inc.	533009	Agent - Casualty	7/25/2023	3/18/2024
Inactive	AssuredPartners New England Inc.	533009	Agent - Property	7/25/2023	3/18/2024
Inactive	Brown & Brown Of Massachusetts, LLC	970275	Agent - Casualty	9/29/2017	3/18/2024
Inactive	Brown & Brown Of Massachusetts, LLC	970275	Agent - Property	9/29/2017	3/18/2024
Inactive	Brown & Brown Of Massachusetts, LLC	970275	Agent - Life	6/3/2019	3/18/2024
Inactive	Brown & Brown Of Massachusetts, LLC	970275	Agent - Health	6/3/2019	3/18/2024