DEPARTMENT OF INSURANCE

Affiliations

Name	American Insurance Administrators Llc	DOIID	395814	NAIC NPN	765507

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Administrator	Not Applicable	2/11/2016	7/6/2018
Active	Non Resident	Agent	Property	6/13/2023		3/31/2027
Active	Non Resident	Agent	Life	6/29/2006		3/31/2027
Active	Non Resident	Agent	Casualty	6/13/2023		3/31/2027
Active	Non Resident	Agent	Health	6/29/2006		3/31/2027
* 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	01/15/2025	03/31/2025	01/02/2025	01/02/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aetna Health Inc. (PA)	660717	Agent - Health	8/29/2024
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/29/2024
Active	Aetna Life Insurance Company	301140	Agent - Health	8/29/2024
Inactive	American General Assurance Company	300586	Agent - Health	3/31/2011	12/31/2012
Inactive	American General Assurance Company	300586	Agent - Life	3/31/2011	12/31/2012
Active	American General Life Insurance Company	301585	Agent - Health	12/31/2012
Active	American General Life Insurance Company	301585	Agent - Life	12/31/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	10/16/2008	12/31/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	10/16/2008	12/31/2012
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	2/27/2007	3/1/2013
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	2/27/2007	3/1/2013
Active	HealthSpring National Health Insurance Company	300235	Agent - Health	5/20/2024
Active	SilverScript Insurance Company	663526	Agent - Health	8/29/2024
Inactive	Time Insurance Company	300683	Agent - Health	5/2/2011	12/20/2014
Inactive	Time Insurance Company	300683	Agent - Life	5/2/2011	12/20/2014
Active	United States Life Insurance Company in the City of New York	301126	Agent - Health	4/20/2011
Active	United States Life Insurance Company in the City of New York	301126	Agent - Life	4/20/2011

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Barlow, Maria	821007	Agent - Health
Denied	Barlow, Maria	821007	Agent - Life
Active	Connor Becher, Elissa Beth	537391	Agent - Health	6/29/2006
Active	Connor Becher, Elissa Beth	537391	Agent - Life	6/29/2006
Inactive	Coulter, Glenn Montgomery	821300	Agent - Health	12/13/2013	12/9/2014
Inactive	Coulter, Glenn Montgomery	821300	Agent - Life	6/18/2014	12/9/2014
Inactive	Gallagher, James Patrick	539991	Administrator - Not Applicable	5/19/2011	10/31/2015
Inactive	Gallagher, James Patrick	539991	Agent - Health	1/30/2007	5/20/2015
Inactive	Gallagher, James Patrick	539991	Agent - Life	1/30/2007	5/20/2015
Inactive	Garrett-Tackett, Lisa Marie	821307	Agent - Health	12/13/2013	6/21/2017
Inactive	Garrett-Tackett, Lisa Marie	821307	Agent - Life	6/16/2014	6/21/2017
Inactive	McMahon, Todd C	717008	Administrator - Not Applicable	2/11/2016	7/6/2018
Active	McMahon, Todd C	717008	Agent - Casualty	6/13/2023
Active	McMahon, Todd C	717008	Agent - Health	1/5/2016
Active	McMahon, Todd C	717008	Agent - Life	5/20/2015
Active	McMahon, Todd C	717008	Agent - Property	6/13/2023
Inactive	Miller, Sandra Lee	825045	Agent - Health	6/12/2014	7/24/2015
Inactive	Miller, Sandra Lee	825045	Agent - Life	6/12/2014	7/24/2015
Active	Montgomery, Joan M	866738	Agent - Health	10/23/2016
Active	Montgomery, Joan M	866738	Agent - Life	10/23/2016
Denied	Mullett, Robert J	358976	Agent - Health
Denied	Mullett, Robert J	358976	Agent - Life
Inactive	Murphy, Barbara Ellen	825096	Agent - Health	6/12/2014	5/26/2017
Inactive	Murphy, Barbara Ellen	825096	Agent - Life	6/12/2014	5/26/2017
Active	Porreca, Daria A	791064	Agent - Health	12/27/2012
Active	Porreca, Daria A	791064	Agent - Life	7/19/2017
Denied	Rehmert, Nicolle Michelle	840764	Agent - Health
Denied	Rehmert, Nicolle Michelle	840764	Agent - Life
Inactive	Super, Philip John	542851	Administrator - Not Applicable	2/25/2008	5/19/2011
Inactive	Super, Philip John	542851	Agent - Health	6/29/2006	5/19/2011
Inactive	Super, Philip John	542851	Agent - Life	6/29/2006	5/19/2011
Inactive	Tiburzio, Nancy C	328822	Administrator - Not Applicable	5/5/1989	11/30/2004
Inactive	Witt, Linda Rebecca	828426	Agent - Health	12/13/2013	11/24/2015
Denied	Xu, Xingchen	838315	Agent - Health
Denied	Xu, Xingchen	838315	Agent - Life
Inactive	Zink, Alan Edward	361093	Administrator - Not Applicable	2/27/1989	6/30/2006
Inactive	Zink, Louise B.	360569	Administrator - Not Applicable	2/27/1989	3/31/1999