DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Excess Risk Underwriters Inc	DOIID	514314	NAIC NPN	1048387

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	10/20/2000		3/31/2026
Active	Non Resident	Agent	Health	3/28/2007		3/31/2026
Active	Non Resident	Agent	Life	3/28/2007		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
Administrator	01/15/2026	03/31/2026
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	American Heritage Life Insurance Company	300272	Agent - Health	4/17/2007	7/18/2016
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	4/17/2007	7/18/2016
Active	Symetra Life Insurance Company	301691	Agent - Health	4/1/2007
Active	Symetra Life Insurance Company	301691	Agent - Life	4/1/2007

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Cullen, Martin Steven	514315	Administrator - Not Applicable	10/20/2000
Active	Cullen, Martin Steven	514315	Agent - Health	3/5/2024
Active	Cullen, Martin Steven	514315	Agent - Life	3/5/2024
Inactive	Rassiga, Frank Stephen	383508	Agent - Health	6/21/2007	2/9/2024
Inactive	Rassiga, Frank Stephen	383508	Agent - Life	6/21/2007	2/9/2024