DEPARTMENT OF INSURANCE
Affiliations
NameAIS Administrators IncDOIID518001NAIC NPN654161
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAdministratorNot Applicable1/13/2010 3/31/2026
ActiveNon ResidentAgentLife3/27/2003 3/31/2026
ActiveNon ResidentAgentCasualty7/6/2004 3/31/2026
ActiveNon ResidentAgentHealth3/27/2003 3/31/2026
ActiveNon ResidentAgentProperty7/2/2004 3/31/2026
InactiveNon ResidentSurplus Lines BrokerNot Applicable8/24/20051/22/2007 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Administrator01/15/202603/31/2026   
Agent01/15/202603/31/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAetna Health Inc.300694Agent - Health6/23/200412/31/2007
InactiveAetna Health Inc. (PA)660717Agent - Health12/31/20077/6/2022
InactiveAetna Life Insurance Company301140Agent - Health6/23/20047/6/2022
InactiveAetna Life Insurance Company301140Agent - Life6/23/20047/6/2022
InactiveAmerican General Assurance Company300586Agent - Health3/5/201012/31/2012
InactiveAmerican General Assurance Company300586Agent - Life3/5/201012/31/2012
ActiveAmerican General Life Insurance Company301585Agent - Health12/31/2012 
ActiveAmerican General Life Insurance Company301585Agent - Life12/31/2012 
InactiveAmerican General Life Insurance Company of Delaware301057Agent - Health3/3/201012/31/2012
InactiveAmerican General Life Insurance Company of Delaware301057Agent - Life3/3/201012/31/2012
InactiveBerkshire Life Insurance Company of America300983Agent - Health6/7/20049/16/2013
InactiveBerkshire Life Insurance Company of America300983Agent - Life6/7/20049/16/2013
InactiveCharter Oak Fire Insurance Company (The)301501Agent - Casualty8/18/20061/16/2007
InactiveCharter Oak Fire Insurance Company (The)301501Agent - Property8/18/20061/16/2007
InactiveFarmington Casualty Company301137Agent - Casualty8/18/20061/16/2007
InactiveFarmington Casualty Company301137Agent - Property8/18/20061/16/2007
InactiveFederal Insurance Company301144Agent - Health3/3/20042/12/2007
InactiveGuardian Life Insurance Company of America301316Agent - Health6/7/200410/5/2021
InactiveGuardian Life Insurance Company of America301316Agent - Life6/7/200410/5/2021
InactiveHartford Life Group Insurance Company301708Agent - Health8/23/200512/31/2006
InactiveHartford Life Group Insurance Company301708Agent - Life8/23/200512/31/2006
ActiveHartford Life and Accident Insurance Company300878Agent - Health8/23/2005 
ActiveHartford Life and Accident Insurance Company300878Agent - Life8/23/2005 
InactiveHumana Health Plan, Inc.300142Agent - Health4/28/200510/18/2006
InactiveHumana Insurance Company301104Agent - Health4/29/200510/18/2006
InactiveHumana Insurance Company301104Agent - Life4/29/200510/18/2006
InactiveHumana Insurance Company of Kentucky300826Agent - Health4/28/200510/18/2006
InactiveHumana Insurance Company of Kentucky300826Agent - Life4/28/200510/18/2006
ActiveMetropolitan Life Insurance Company301948Agent - Health1/28/2010 
ActiveMetropolitan Life Insurance Company301948Agent - Life1/28/2010 
ActiveNew York Life Insurance Company300431Agent - Health4/21/2010 
ActiveNew York Life Insurance Company300431Agent - Life4/21/2010 
InactiveProgressive Casualty Insurance Company300696Agent - Casualty7/22/20046/7/2005
InactiveProgressive Casualty Insurance Company300696Agent - Property7/22/20046/7/2005
InactiveProgressive Northern Insurance Company301378Agent - Casualty7/22/20046/7/2005
InactiveProgressive Northern Insurance Company301378Agent - Property7/22/20046/7/2005
InactiveProvident Life and Accident Insurance Company301525Agent - Health8/3/200412/30/2009
InactiveProvident Life and Accident Insurance Company301525Agent - Life8/3/200412/30/2009
InactiveResponse Worldwide Insurance Company301194Agent - Casualty4/7/200512/28/2007
InactiveResponse Worldwide Insurance Company301194Agent - Property4/7/200512/28/2007
InactiveStandard Fire Insurance Company (The)301068Agent - Casualty8/18/20061/16/2007
InactiveStandard Fire Insurance Company (The)301068Agent - Property8/18/20061/16/2007
InactiveThe Phoenix Insurance Company301502Agent - Casualty8/18/20061/16/2007
InactiveThe Phoenix Insurance Company301502Agent - Property8/18/20061/16/2007
InactiveTime Insurance Company300683Agent - Health4/13/20049/26/2007
InactiveTime Insurance Company300683Agent - Life4/13/20049/26/2007
InactiveTravelers Casualty Insurance Company of America300522Agent - Casualty8/18/20061/16/2007
InactiveTravelers Casualty Insurance Company of America300522Agent - Property8/18/20061/16/2007
InactiveTravelers Casualty and Surety Company301067Agent - Casualty8/18/20061/16/2007
InactiveTravelers Casualty and Surety Company301067Agent - Property8/18/20061/16/2007
InactiveTravelers Commercial Casualty Company301695Agent - Casualty8/18/20061/16/2007
InactiveTravelers Commercial Casualty Company301695Agent - Property8/18/20061/16/2007
InactiveTravelers Indemnity Company (The)301855Agent - Casualty8/18/20061/16/2007
InactiveTravelers Indemnity Company (The)301855Agent - Property8/18/20061/16/2007
InactiveTravelers Indemnity Company of America (The)301093Agent - Casualty8/18/20061/16/2007
InactiveTravelers Indemnity Company of America (The)301093Agent - Property8/18/20061/16/2007
InactiveTravelers Indemnity Company of Connecticut (The)301591Agent - Casualty8/18/20061/16/2007
InactiveTravelers Indemnity Company of Connecticut (The)301591Agent - Property8/18/20061/16/2007
InactiveTravelers Property Casualty Company of America301649Agent - Casualty8/18/20061/16/2007
InactiveTravelers Property Casualty Company of America301649Agent - Property8/18/20061/16/2007
InactiveUNUM Life Insurance Company of America300817Agent - Health8/3/200412/30/2009
InactiveUNUM Life Insurance Company of America300817Agent - Life8/3/200412/30/2009
ActiveUnited States Life Insurance Company in the City of New York301126Agent - Health7/19/2004 
ActiveUnited States Life Insurance Company in the City of New York301126Agent - Life7/19/2004 
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
DeniedBabnik, Marielle Mentzer 566049Agent - Health  
DeniedBabnik, Marielle Mentzer 566049Agent - Life  
InactiveBartee, Robert B 375562Agent - Casualty9/27/200510/31/2006
InactiveBartee, Robert B 375562Agent - Health9/27/200510/31/2006
InactiveBartee, Robert B 375562Agent - Life9/27/200510/31/2006
InactiveBartee, Robert B 375562Agent - Property9/27/200510/31/2006
ActiveBenoit, Ronald J 652339Administrator - Not Applicable1/13/2010 
ActiveBenoit, Ronald J 652339Agent - Casualty5/9/2008 
ActiveBenoit, Ronald J 652339Agent - Health3/27/2008 
ActiveBenoit, Ronald J 652339Agent - Life3/27/2008 
ActiveBenoit, Ronald J 652339Agent - Property5/9/2008 
InactiveCarney, Georgianna 564822Agent - Casualty7/6/20046/5/2006
InactiveCarney, Georgianna 564822Agent - Property7/2/20046/5/2006
InactiveCarroll, William Michael 359730Administrator - Not Applicable10/31/200011/6/2006
DeniedCorney, Susan Elizabeth 564821Agent - Health  
DeniedCorney, Susan Elizabeth 564821Agent - Life  
DeniedGraff, James Gilbert 564981Agent - Casualty  
DeniedGraff, James Gilbert 564981Agent - Property  
InactiveHickey, Gary P 354877Administrator - Not Applicable10/31/200010/26/2006
InactiveHickey, Gary P 354877Agent - Health4/12/20036/5/2006
InactiveHickey, Gary P 354877Agent - Life4/12/20036/5/2006
InactiveHudon, David B 652340Administrator - Not Applicable2/9/20106/30/2017
InactiveHudon, David B 652340Agent - Health3/31/20086/19/2017
InactiveHudon, David B 652340Agent - Life3/31/20086/19/2017
InactiveScarborough, Jay Ross 554462Agent - Casualty1/18/20058/22/2006
InactiveScarborough, Jay Ross 554462Agent - Property1/18/20058/22/2006
InactiveScarborough, Jay Ross 554462Surplus Lines Broker - Not Applicable8/24/200510/23/2006
InactiveSchanen, Robert Paul 535732Agent - Health10/31/20063/20/2025
InactiveSchanen, Robert Paul 535732Agent - Life10/31/20063/20/2025
DeniedStalls, Laura 1163443Agent - Health  
DeniedStalls, Laura 1163443Agent - Life  
InactiveWilcox, Benjamin Davis William 576594Agent - Casualty10/31/20061/19/2010
InactiveWilcox, Benjamin Davis William 576594Agent - Property10/31/20061/19/2010
InactiveWilcox, Benjamin Davis William 576594Surplus Lines Broker - Not Applicable10/31/20061/22/2007
InactiveWilson, Patricia A 610684Agent - Casualty6/5/200610/23/2006
InactiveWilson, Patricia A 610684Agent - Property6/5/200610/23/2006

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