DEPARTMENT OF INSURANCE

Affiliations

Name	Delarosa, Richard A	DOIID	324947	NAIC NPN	54911

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/13/2024		5/31/2027
Active	Non Resident	Agent	Property	2/7/2025		5/31/2027
Active	Non Resident	Agent	Casualty	2/7/2025		5/31/2027
Inactive	Non Resident	Agent	Health Maintenance Organization	3/2/1999	7/26/1999
Inactive	Non Resident	Agent	Life	6/9/1999	7/26/1999
* 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	03/15/2027	05/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Connect Property and Casualty Insurance Company	622403	Agent - Casualty	2/11/2025
Active	American Family Connect Property and Casualty Insurance Company	622403	Agent - Property	2/11/2025
Active	American Modern Home Insurance Company	300791	Agent - Casualty	2/27/2025
Active	American Modern Home Insurance Company	300791	Agent - Property	2/27/2025
Active	Bristol West Insurance Company	301655	Agent - Casualty	8/22/2025
Active	Bristol West Insurance Company	301655	Agent - Property	8/22/2025
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/20/2013	12/1/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	8/20/2013	12/1/2016
Active	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	9/23/2024
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	8/22/2025
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	8/22/2025
Active	Homesite Insurance Company	301139	Agent - Casualty	2/11/2025
Active	Homesite Insurance Company	301139	Agent - Property	2/11/2025
Active	Homesite Insurance Company of the Midwest	874850	Agent - Casualty	2/11/2025
Active	Homesite Insurance Company of the Midwest	874850	Agent - Property	2/11/2025
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	12/1/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	8/20/2013	12/1/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/20/2013	12/1/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	3/2/1999	7/26/1999
Inactive	Humana Insurance Company	300118	Agent - Health	6/9/1999	7/26/1999
Inactive	Humana Insurance Company	301104	Agent - Health	8/20/2013	12/1/2016
Inactive	Humana Insurance Company	300118	Agent - Life	6/9/1999	7/26/1999
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/20/2013	12/1/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	12/1/2016
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	12/1/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/20/2013	10/22/2015
Active	Midvale Indemnity Company	300292	Agent - Casualty	2/11/2025
Active	Midvale Indemnity Company	300292	Agent - Property	2/11/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Connect Insurance Agency, Inc.	619157	Agent - Casualty	3/3/2025
Active	American Family Connect Insurance Agency, Inc.	619157	Agent - Property	3/3/2025