DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Agent Support Services LLC	DOIID	1087785	NAIC NPN	964513

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	12/28/2024		3/31/2026
Active	Non Resident	Agent	Health	12/28/2024		3/31/2026
* 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	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Guaranty Income Life Insurance Company	552451	Agent - Health	2/15/2023	11/1/2024
Inactive	Guaranty Income Life Insurance Company	552451	Agent - Life	2/15/2023	11/1/2024
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	1/20/2021	11/1/2024
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	1/20/2021	11/1/2024
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Health	6/30/2020	11/1/2024
Inactive	Nationwide Life and Annuity Insurance Company	300714	Agent - Life	6/30/2020	11/1/2024
Inactive	Pruco Life Insurance Company	300954	Agent - Health	4/7/2022	11/1/2024
Active	Pruco Life Insurance Company	300954	Agent - Life	2/7/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Graham, Mark Burnside	638756	Agent - Health	1/27/2021	8/31/2024
Inactive	Graham, Mark Burnside	638756	Agent - Life	1/27/2021	8/31/2024
Inactive	Kaufman, Samuel J	536693	Agent - Health	6/30/2020	1/27/2021
Inactive	Kaufman, Samuel J	536693	Agent - Life	6/30/2020	1/27/2021
Active	Scheiner, Jay L	1246386	Agent - Health	12/28/2024
Active	Scheiner, Jay L	1246386	Agent - Life	12/28/2024