DEPARTMENT OF INSURANCE

Affiliations

Name	Willis, Mark Allen	DOIID	346589	NAIC NPN	1004834

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	10/8/2001		5/31/2027
Active	Non Resident	Agent	Casualty	8/15/2000		5/31/2027
Active	Non Resident	Agent	Health	10/8/2001		5/31/2027
Active	Non Resident	Agent	Variable Life and Variable Annuities	10/9/2001		5/31/2027
Active	Non Resident	Agent	Property	8/15/2000		5/31/2027
Inactive	Non Resident	Agent	General Lines	7/28/1997	8/15/2000
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	03/15/2025	05/31/2025	05/01/2025	05/01/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc.	300694	Agent - Health	5/4/2006	12/31/2007
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	12/31/2007	7/6/2017
Inactive	Aetna Life Insurance Company	301140	Agent - Health	5/4/2006	7/6/2017
Inactive	Aetna Life Insurance Company	301140	Agent - Life	5/4/2006	7/6/2017
Inactive	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019	5/27/2022
Inactive	American Economy Insurance Company	300315	Agent - Property	11/9/2019	5/27/2022
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	8/15/2000	10/15/2021
Inactive	American Fire and Casualty Company	300567	Agent - General Lines	7/28/1997	8/15/2000
Inactive	American Fire and Casualty Company	300567	Agent - Property	8/15/2000	10/15/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	12/4/2017	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	12/4/2017	11/14/2021
Active	Ansur America Insurance Company	520667	Agent - Casualty	2/18/2008
Active	Ansur America Insurance Company	520667	Agent - Property	2/18/2008
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/31/2025
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	9/26/2021	12/19/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	9/26/2021
Active	Auto-Owners Insurance Company	301480	Agent - Casualty	11/10/2003
Active	Auto-Owners Insurance Company	301480	Agent - Property	11/10/2003
Inactive	Beazley Insurance Company, Inc.	300899	Agent - Casualty	10/17/2002	6/17/2005
Inactive	Beazley Insurance Company, Inc.	300899	Agent - Property	10/17/2002	6/17/2005
Active	BrickStreet Mutual Insurance Company	709251	Agent - Casualty	1/15/2021
Inactive	Bridgefield Casualty Insurance Company	500013	Agent - Casualty	5/16/2022	12/11/2023
Inactive	C.M. Life Insurance Company	301335	Agent - Health	7/14/2004	11/9/2012
Inactive	C.M. Life Insurance Company	301335	Agent - Life	7/14/2004	11/9/2012
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	8/25/2023	11/26/2024
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	8/25/2023	11/26/2024
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Health	11/8/2010
Active	Cincinnati Life Insurance Company (The)	300601	Agent - Life	10/29/2010
Active	Colonial Life and Accident Insurance Company	300846	Agent - Health	6/24/2024
Active	Colonial Life and Accident Insurance Company	300846	Agent - Life	6/24/2024
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	9/26/2021
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	9/8/2007	10/13/2022
Inactive	Consolidated Insurance Company	300943	Agent - Property	9/8/2007	10/13/2022
Active	EMC Property & Casualty Company	955217	Agent - Casualty	5/20/2021
Active	EMC Property & Casualty Company	955217	Agent - Property	5/20/2021
Active	EMCASCO Insurance Company	842790	Agent - Casualty	3/21/2019
Active	EMCASCO Insurance Company	842790	Agent - Property	3/21/2019
Active	Employers Mutual Casualty Company	300202	Agent - Casualty	3/21/2019
Active	Employers Mutual Casualty Company	300202	Agent - Property	3/21/2019
Inactive	First National Insurance Company of America	301690	Agent - Casualty	10/7/2008	10/15/2021
Inactive	First National Insurance Company of America	301690	Agent - Property	10/7/2008	10/15/2021
Active	Frankenmuth Insurance Company	301481	Agent - Casualty	6/15/2006
Active	Frankenmuth Insurance Company	301481	Agent - Property	6/15/2006
Inactive	General American Life Insurance Company	300280	Agent - Health	10/8/2001	11/19/2009
Inactive	General American Life Insurance Company	300280	Agent - Life	10/8/2001	11/19/2009
Inactive	General American Life Insurance Company	300280	Agent - Variable Life and Variable Annuities	10/9/2001	10/18/2010
Inactive	General Insurance Company of America	300261	Agent - Casualty	10/7/2008	10/15/2021
Inactive	General Insurance Company of America	300261	Agent - Property	10/7/2008	10/15/2021
Inactive	Indiana Insurance Company	301909	Agent - Casualty	9/8/2007	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	9/8/2007	2/3/2023
Inactive	Individual Assurance Company Life Health & Accident	300580	Agent - Health	10/15/2003	5/12/2015
Inactive	Individual Assurance Company Life Health & Accident	300580	Agent - Life	10/15/2003	5/12/2015
Active	MICO Insurance Company	301664	Agent - Casualty	11/24/2021
Active	MICO Insurance Company	301664	Agent - Property	11/24/2021
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Health	7/14/2004	11/9/2012
Inactive	Massachusetts Mutual Life Insurance Company	300445	Agent - Life	7/14/2004	11/9/2012
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	9/8/2007	4/26/2024
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	9/8/2007	4/26/2024
Inactive	New England Life Insurance Company	300343	Agent - Health	8/5/2003	12/2/2009
Inactive	New England Life Insurance Company	300343	Agent - Life	8/5/2003	12/2/2009
Inactive	New England Life Insurance Company	300343	Agent - Variable Life and Variable Annuities	8/5/2003	10/18/2010
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Health	7/10/2002	1/29/2009
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	7/10/2002	1/29/2009
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Variable Life and Variable Annuities	7/10/2002	1/29/2009
Active	NorthStone Insurance Company	818905	Agent - Casualty	1/15/2021
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	8/15/2000	5/27/2022
Inactive	Ohio Casualty Insurance Company	301492	Agent - General Lines	7/28/1997	8/15/2000
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	8/15/2000	5/27/2022
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	8/15/2000	10/15/2021
Inactive	Ohio Security Insurance Company	300622	Agent - General Lines	7/28/1997	8/15/2000
Inactive	Ohio Security Insurance Company	300622	Agent - Property	8/15/2000	10/15/2021
Active	Owners Insurance Company	300796	Agent - Casualty	11/10/2003
Active	Owners Insurance Company	300796	Agent - Property	11/10/2003
Active	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/8/2007
Active	Peerless Indemnity Insurance Company	571682	Agent - Property	9/8/2007
Inactive	Peerless Insurance Company	301910	Agent - Casualty	9/8/2007	5/8/2025
Inactive	Peerless Insurance Company	301910	Agent - Property	9/8/2007	5/8/2025
Active	PinnaclePoint Insurance Company	819085	Agent - Casualty	1/15/2021
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	10/7/2008
Active	SAFECO Insurance Company of America	300159	Agent - Property	10/7/2008
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	10/7/2008	5/27/2022
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	10/7/2008	5/27/2022
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	8/25/2023	11/26/2024
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	8/25/2023	11/26/2024
Inactive	Stillwater Insurance Company	567181	Agent - Casualty	8/27/2003	12/17/2003
Inactive	Stillwater Insurance Company	567181	Agent - Property	8/27/2003	12/17/2003
Active	SummitPoint Insurance Company	819084	Agent - Casualty	1/15/2021
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Health	9/11/2007	11/3/2009
Inactive	Sun Life Assurance Company of Canada	301811	Agent - Life	9/11/2007	11/3/2009
Active	The Phoenix Insurance Company	301502	Agent - Casualty	8/25/2023
Active	The Phoenix Insurance Company	301502	Agent - Property	8/25/2023
Active	Travelers Indemnity Company (The)	301855	Agent - Casualty	8/25/2023
Active	Travelers Indemnity Company (The)	301855	Agent - Property	8/25/2023
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	8/25/2023	11/26/2024
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	8/25/2023	11/26/2024
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	8/25/2023	11/26/2024
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	8/25/2023	11/26/2024
Active	Travelers Property Casualty Company of America	301649	Agent - Casualty	8/25/2023
Active	Travelers Property Casualty Company of America	301649	Agent - Property	8/25/2023
Active	Union Insurance Company of Providence	842791	Agent - Casualty	3/21/2019
Active	Union Insurance Company of Providence	842791	Agent - Property	3/21/2019
Inactive	West American Insurance Company	301112	Agent - Casualty	8/15/2000	5/27/2022
Inactive	West American Insurance Company	301112	Agent - General Lines	7/28/1997	8/15/2000
Inactive	West American Insurance Company	301112	Agent - Property	8/15/2000	5/27/2022
Active	Westfield Insurance Company	301950	Agent - Casualty	1/4/2010
Active	Westfield Insurance Company	301950	Agent - Property	1/4/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	CBISA Reaquisitian Corp	547026	Agent - Health	11/19/2010
Active	CBISA Reaquisitian Corp	547026	Agent - Life	11/19/2010
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/6/2013	2/17/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/6/2013	2/17/2025
Inactive	First Financial Ins Inc	596684	Agent - Property	7/18/2002	5/18/2009
Inactive	First Financial Ins Inc	596684	Agent - Casualty	7/18/2002	5/18/2009
Inactive	First Financial Life Insurance, Inc.	552979	Agent - Health	8/16/2004	5/18/2009
Inactive	First Financial Life Insurance, Inc.	552979	Agent - Life	7/18/2002	5/18/2009
Inactive	Knight-Willis Ins Agency Llc	718047	Agent - Property	1/3/2011	2/10/2025
Inactive	Knight-Willis Ins Agency Llc	718047	Agent - Casualty	1/3/2011	2/10/2025
Inactive	Knight-Willis Ins Agency Llc	718047	Agent - Health	11/5/2010	2/10/2025
Inactive	Knight-Willis Ins Agency Llc	718047	Agent - Life	10/21/2010	2/10/2025