DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Insurance Supermarket Inc	DOIID	1097492	NAIC NPN	16958348

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	10/4/2023	4/1/2025
Active	Non Resident	Agent	Life	9/10/2020		3/31/2028
* 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	Assurity Life Insurance Company	301099	Agent - Life	5/27/2021	10/5/2022
Active	EMC National Life Company	300388	Agent - Life	11/18/2025
Inactive	Guarantee Trust Life Insurance Company	301043	Agent - Life	9/28/2020	9/16/2024
Active	Monitor Life Insurance Company of New York	1117550	Agent - Life	2/22/2024
Active	Pioneer American Insurance Company	301268	Agent - Life	6/30/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fonseca, Vanessa Diane	1276254	Administrator - Not Applicable	10/4/2023	1/31/2025
Inactive	Medina, Victoria	1094383	Agent - Life	9/10/2020	2/9/2026
Active	Rowe, Beahelasher Desair	1017468	Agent - Life	2/9/2026