DEPARTMENT OF INSURANCE
Affiliations
NamePremiere Senior Insurance Services Inc
DBA : Premier Insurance Services
DOIID672379NAIC NPN7518090
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife3/5/2008 3/31/2026
ActiveNon ResidentAgentHealth3/5/2008 3/31/2026
ActiveNon ResidentAgentProperty3/5/2008 3/31/2026
ActiveNon ResidentAgentCasualty3/5/2008 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
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202603/31/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAetna Health Inc. (PA)660717Agent - Health12/11/2013 
ActiveAetna Health of Ohio Inc.1065035Agent - Health7/25/2020 
ActiveAetna Life Insurance Company301140Agent - Health12/11/2013 
ActiveAetna Life Insurance Company301140Agent - Life12/11/2013 
InactiveAmerican Commerce Insurance Company301665Agent - Casualty10/2/20144/28/2017
InactiveAmerican Commerce Insurance Company301665Agent - Property10/2/20144/28/2017
InactiveAmerican Economy Insurance Company300315Agent - Casualty6/3/20093/29/2024
InactiveAmerican Economy Insurance Company300315Agent - Property6/3/20093/29/2024
InactiveAmerican Family Home Insurance Company301817Agent - Casualty10/20/201511/14/2021
InactiveAmerican Family Home Insurance Company301817Agent - Property10/20/201511/14/2021
InactiveAmerican Fire and Casualty Company300567Agent - Casualty6/3/20093/29/2024
InactiveAmerican Fire and Casualty Company300567Agent - Property6/3/20093/29/2024
ActiveAmerican Modern Home Insurance Company300791Agent - Casualty5/1/2012 
ActiveAmerican Modern Home Insurance Company300791Agent - Property5/1/2012 
ActiveAmerican Modern Property and Casualty Insurance Company301954Agent - Casualty5/28/2018 
ActiveAmerican Modern Property and Casualty Insurance Company301954Agent - Property5/28/2018 
InactiveAmerican Modern Select Insurance Company581481Agent - Casualty5/1/201211/14/2021
InactiveAmerican Modern Select Insurance Company581481Agent - Property5/1/201211/14/2021
InactiveAmerican Retirement Life Insurance Company706303Agent - Health12/16/201512/21/2018
InactiveAmerican Retirement Life Insurance Company706303Agent - Life12/16/201512/21/2018
InactiveAmerican Southern Home Insurance Company626276Agent - Casualty5/1/201211/14/2021
InactiveAmerican Southern Home Insurance Company626276Agent - Property5/1/201211/14/2021
InactiveAmerican States Insurance Company301230Agent - Casualty6/3/20093/29/2024
InactiveAmerican States Insurance Company301230Agent - Property6/3/20093/29/2024
ActiveAmerican Strategic Insurance Corp883540Agent - Casualty6/4/2020 
ActiveAmerican Strategic Insurance Corp883540Agent - Property6/4/2020 
InactiveAmerico Financial Life and Annuity Insurance Company300869Agent - Life4/26/201312/18/2018
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health9/1/2017 
InactiveAnthem Health Plans of New Hampshire, Inc.944064Agent - Health10/6/202112/19/2024
ActiveAnthem Insurance Companies, Inc.300941Agent - Health6/12/2021 
InactiveArcadian Health Plan, Inc.728196Agent - Health10/18/20174/29/2019
ActiveAutomobile Insurance Company of Hartford, Connecticut300630Agent - Casualty9/1/2020 
ActiveAutomobile Insurance Company of Hartford, Connecticut300630Agent - Property9/1/2020 
InactiveCIGNA Health & Life Insurance Company301783Agent - Health10/10/201712/21/2018
InactiveCIGNA Health & Life Insurance Company301783Agent - Life10/10/201712/21/2018
ActiveCare Improvement Plus South Central Insurance Company799697Agent - Health7/20/2022 
InactiveCombined Insurance Company of America301472Agent - Health4/1/20164/13/2020
InactiveCompBenefits Dental, Inc.591692Agent - Health5/28/201312/8/2015
ActiveCompcare Health Services Insurance Corporation948751Agent - Health10/6/2021 
InactiveConsolidated Insurance Company300943Agent - Casualty5/13/200810/13/2022
InactiveConsolidated Insurance Company300943Agent - Property5/13/200810/13/2022
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health8/10/2018 
ActiveCoventry Health and Life Insurance Company301771Agent - Health9/1/2014 
InactiveDental Concern Inc. (The)301641Agent - Health5/28/201312/8/2015
InactiveEncompass Indemnity Company546376Agent - Casualty5/5/200810/3/2024
InactiveEncompass Indemnity Company546376Agent - Property5/5/200810/3/2024
ActiveEncompass Insurance Company300188Agent - Casualty6/18/2024 
ActiveEncompass Insurance Company300188Agent - Property6/18/2024 
InactiveEncompass Insurance Company of America556578Agent - Casualty5/19/201112/13/2018
InactiveEncompass Insurance Company of America556578Agent - Property5/19/201112/13/2018
InactiveEncova Life Insurance Company301818Agent - Life3/13/20091/1/2024
ActiveFarmers Property and Casualty Insurance Company301237Agent - Casualty4/25/2008 
ActiveFarmers Property and Casualty Insurance Company301237Agent - Property4/25/2008 
ActiveFirst Health Life & Health Insurance Company301735Agent - Health9/1/2014 
InactiveFirst National Insurance Company of America301690Agent - Casualty10/16/200810/13/2022
InactiveFirst National Insurance Company of America301690Agent - Property10/16/200810/13/2022
InactiveForethought Life Insurance Company301407Agent - Health12/30/20101/6/2015
InactiveForethought Life Insurance Company301407Agent - Life12/30/20101/6/2015
InactiveGeneral Insurance Company of America300261Agent - Casualty10/16/20083/29/2024
InactiveGeneral Insurance Company of America300261Agent - Property10/16/20083/29/2024
ActiveGerber Life Insurance Company300529Agent - Health12/8/2013 
ActiveGerber Life Insurance Company300529Agent - Life12/8/2013 
InactiveGolden Rule Insurance Company301943Agent - Health5/11/201512/13/2016
InactiveGolden Rule Insurance Company301943Agent - Life5/11/201512/14/2016
ActiveGrange Indemnity Insurance Company300793Agent - Casualty9/16/2009 
ActiveGrange Indemnity Insurance Company300793Agent - Property9/16/2009 
ActiveGrange Insurance Company300234Agent - Casualty9/16/2009 
ActiveGrange Insurance Company300234Agent - Property9/16/2009 
InactiveGrange Life Insurance Company300128Agent - Health9/16/20093/31/2021
InactiveGrange Life Insurance Company300128Agent - Life9/16/20093/31/2021
ActiveGrange Property & Casualty Insurance Company601680Agent - Casualty9/16/2009 
ActiveGrange Property & Casualty Insurance Company601680Agent - Property9/16/2009 
InactiveGuarantee Trust Life Insurance Company301043Agent - Health12/19/20121/2/2019
InactiveGuarantee Trust Life Insurance Company301043Agent - Life12/19/20121/2/2019
InactiveGuideOne Elite Insurance Company300490Agent - Casualty3/25/20081/21/2022
InactiveGuideOne Elite Insurance Company300490Agent - Property3/25/20081/21/2022
InactiveGuideOne Insurance Company301794Agent - Casualty3/25/20081/21/2022
InactiveGuideOne Insurance Company301794Agent - Property3/25/20081/21/2022
InactiveGuideOne Specialty Insurance Company300278Agent - Casualty3/25/20081/21/2022
InactiveGuideOne Specialty Insurance Company300278Agent - Property3/25/20081/21/2022
InactiveHallmark National Insurance Company300494Agent - Casualty2/24/20101/8/2018
InactiveHallmark National Insurance Company300494Agent - Property2/24/20101/8/2018
ActiveHartford Accident and Indemnity Company301917Agent - Casualty4/12/2013 
ActiveHartford Accident and Indemnity Company301917Agent - Property4/12/2013 
InactiveHartford Underwriters Insurance Company301064Agent - Casualty2/17/201512/5/2018
InactiveHartford Underwriters Insurance Company301064Agent - Property2/17/201512/5/2018
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health5/28/201312/13/2016
InactiveHumana Health Plan, Inc.300142Agent - Health1/18/20176/15/2018
InactiveHumana Insurance Company301104Agent - Health5/28/201312/13/2016
InactiveHumana Insurance Company301104Agent - Life5/28/201312/13/2016
InactiveHumana Insurance Company of Kentucky300826Agent - Health5/28/201312/8/2015
InactiveHumana Insurance Company of Kentucky300826Agent - Life5/28/201312/8/2015
InactiveHumana Medical Plan, Inc.801568Agent - Health11/24/201512/13/2016
InactiveHumana Wisconsin Health Organization Insurance Corporation830687Agent - Health12/1/20166/15/2018
InactiveIndiana Insurance Company301909Agent - Casualty5/13/20082/3/2023
InactiveIndiana Insurance Company301909Agent - Property5/13/20082/3/2023
InactiveKanawha Insurance Company300127Agent - Health5/28/201310/22/2015
InactiveKanawha Insurance Company300127Agent - Life5/28/201310/22/2015
InactiveMedico Corp Life Insurance Company301777Agent - Health9/21/20153/14/2018
InactiveMedico Corp Life Insurance Company301777Agent - Life9/21/20153/14/2018
InactiveMedico Insurance Company301559Agent - Health8/28/201212/26/2018
InactiveMedico Insurance Company301559Agent - Life8/28/201212/26/2018
InactiveMedico Life and Health Insurance Company907406Agent - Health2/27/202112/21/2022
InactiveMedico Life and Health Insurance Company907406Agent - Life2/27/202112/21/2022
InactiveMeridian Security Insurance Company300423Agent - Casualty2/24/20101/7/2014
InactiveMeridian Security Insurance Company300423Agent - Property2/24/20101/7/2014
InactiveMetropolitan General Insurance Company300709Agent - Casualty4/25/200812/24/2020
InactiveMetropolitan General Insurance Company300709Agent - Property4/25/200812/24/2020
InactiveMutual of Omaha Insurance Company301012Agent - Health3/19/200812/26/2012
ActiveNational General Insurance Company300152Agent - Casualty9/27/2011 
ActiveNational General Insurance Company300152Agent - Property9/27/2011 
ActiveNational Specialty Insurance Company300993Agent - Casualty7/19/2022 
ActiveNational Specialty Insurance Company300993Agent - Property7/19/2022 
InactiveNetherlands Insurance Company (The)300339Agent - Casualty5/13/20085/9/2024
InactiveNetherlands Insurance Company (The)300339Agent - Property5/13/20085/9/2024
InactiveNext Insurance US Company1083825Agent - Casualty7/18/20224/29/2025
InactiveNext Insurance US Company1083825Agent - Property7/18/20224/29/2025
ActiveNorth American Company for Life and Health Insurance300291Agent - Life9/23/2020 
ActiveOhio Casualty Insurance Company301492Agent - Casualty5/30/2008 
ActiveOhio Casualty Insurance Company301492Agent - Property5/30/2008 
ActiveOhio Security Insurance Company300622Agent - Casualty5/28/2024 
ActiveOhio Security Insurance Company300622Agent - Property5/28/2024 
InactiveOmaha Insurance Company751908Agent - Health3/30/20126/24/2013
InactivePacifiCare Life and Health Insurance Company301304Agent - Health9/11/200911/4/2011
ActivePan-American Life Insurance Company301530Agent - Life1/1/2024 
InactivePeerless Indemnity Insurance Company571682Agent - Casualty5/13/20089/26/2024
InactivePeerless Indemnity Insurance Company571682Agent - Property5/13/20089/26/2024
InactivePeerless Insurance Company301910Agent - Casualty5/13/20085/8/2025
InactivePeerless Insurance Company301910Agent - Property5/13/20085/8/2025
ActiveProgressive Casualty Insurance Company300696Agent - Casualty4/4/2008 
ActiveProgressive Casualty Insurance Company300696Agent - Property4/4/2008 
InactiveProgressive Northern Insurance Company301378Agent - Casualty4/4/200812/9/2013
InactiveProgressive Northern Insurance Company301378Agent - Property4/4/200812/9/2013
InactiveSAFECO Insurance Company of America300159Agent - Casualty10/16/20083/29/2024
InactiveSAFECO Insurance Company of America300159Agent - Property10/16/20083/29/2024
InactiveSAFECO Insurance Company of Illinois301350Agent - Casualty10/16/20083/29/2024
InactiveSAFECO Insurance Company of Illinois301350Agent - Property10/16/20083/29/2024
ActiveSentinel Insurance Company, Limited501696Agent - Casualty9/16/2008 
ActiveSentinel Insurance Company, Limited501696Agent - Property9/16/2008 
ActiveSilverScript Insurance Company663526Agent - Health2/26/2020 
ActiveStandard Fire Insurance Company (The)301068Agent - Casualty7/10/2014 
ActiveStandard Fire Insurance Company (The)301068Agent - Property7/10/2014 
InactiveStandard Security Life Insurance Company of NY301487Agent - Health4/2/201012/27/2018
InactiveStandard Security Life Insurance Company of NY301487Agent - Life4/2/201012/27/2018
InactiveState Auto Property & Casualty Insurance Company301953Agent - Casualty2/24/20101/7/2014
InactiveState Auto Property & Casualty Insurance Company301953Agent - Property2/24/20101/7/2014
InactiveState Automobile Mutual Insurance Company301824Agent - Casualty2/24/20101/7/2014
InactiveState Automobile Mutual Insurance Company301824Agent - Property2/24/20101/7/2014
ActiveState National Insurance Company, Inc.300888Agent - Casualty7/19/2022 
ActiveState National Insurance Company, Inc.300888Agent - Property7/19/2022 
InactiveThe Phoenix Insurance Company301502Agent - Casualty4/21/200812/9/2013
InactiveThe Phoenix Insurance Company301502Agent - Property4/21/200812/9/2013
InactiveTitan Indemnity Company300556Agent - Casualty3/3/20116/22/2017
InactiveTitan Indemnity Company300556Agent - Property3/3/20116/22/2017
InactiveTransamerica Premier Life Insurance Company300558Agent - Health9/8/20113/15/2013
InactiveTransamerica Premier Life Insurance Company300558Agent - Life9/8/20113/15/2013
InactiveTravelers Commercial Insurance Company301506Agent - Casualty4/21/200812/9/2013
InactiveTravelers Commercial Insurance Company301506Agent - Property4/21/200812/9/2013
ActiveTravelers Home and Marine Insurance Company (The)301802Agent - Casualty4/21/2008 
ActiveTravelers Home and Marine Insurance Company (The)301802Agent - Property4/21/2008 
InactiveTravelers Indemnity Company (The)301855Agent - Casualty4/21/200812/9/2013
InactiveTravelers Indemnity Company (The)301855Agent - Property4/21/200812/9/2013
InactiveTravelers Indemnity Company of America (The)301093Agent - Casualty4/21/200812/9/2013
InactiveTravelers Indemnity Company of America (The)301093Agent - Property4/21/200812/9/2013
ActiveTravelers Personal Insurance Company705785Agent - Casualty8/14/2019 
ActiveTravelers Personal Insurance Company705785Agent - Property8/14/2019 
ActiveTrexis Insurance Corporation599902Agent - Casualty3/13/2012 
ActiveTrexis One Insurance Corporation684197Agent - Casualty4/5/2012 
ActiveTrustgard Insurance Company300104Agent - Casualty9/16/2009 
ActiveTrustgard Insurance Company300104Agent - Property9/16/2009 
ActiveUnited Financial Casualty Company301886Agent - Casualty4/4/2008 
ActiveUnited Financial Casualty Company301886Agent - Property4/4/2008 
InactiveUnited World Life Insurance Company300532Agent - Health3/19/200812/15/2010
InactiveUnited of Omaha Life Insurance Company300156Agent - Health3/19/200812/26/2012
InactiveUnited of Omaha Life Insurance Company300156Agent - Life3/19/200812/26/2012
ActiveUnitedHealthcare Insurance Company300946Agent - Health2/5/2016 
ActiveUnitedHealthcare Insurance Company300946Agent - Life2/5/2016 
InactiveUnitedHealthcare Insurance Company of America301552Agent - Health9/16/201612/20/2018
InactiveUnitedHealthcare Insurance Company of the River Valley1027817Agent - Health8/5/201912/22/2022
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health7/15/201812/23/2021
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health9/8/201112/1/2016
ActiveUnitedHealthcare of Wisconsin, Inc.871491Agent - Health9/11/2015 
InactiveUnitrin Auto and Home Insurance Company301538Agent - Casualty1/10/201310/23/2024
InactiveUnitrin Auto and Home Insurance Company301538Agent - Property1/10/201310/23/2024
InactiveUnitrin Preferred Insurance Company502869Agent - Casualty1/10/201312/2/2013
InactiveUnitrin Preferred Insurance Company502869Agent - Property1/10/201312/2/2013
InactiveUnitrin Safeguard Insurance Company301371Agent - Casualty10/11/201810/23/2024
InactiveUnitrin Safeguard Insurance Company301371Agent - Property10/11/201810/23/2024
InactiveVictoria Fire & Casualty Company300313Agent - Casualty5/6/20116/22/2017
InactiveVictoria Fire & Casualty Company300313Agent - Property5/6/20116/22/2017
InactiveWest American Insurance Company301112Agent - Casualty5/30/20083/29/2024
InactiveWest American Insurance Company301112Agent - Property5/30/20083/29/2024
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveKofalt, Mark T 366693Agent - Casualty3/25/2008 
ActiveKofalt, Mark T 366693Agent - Health3/5/2008 
ActiveKofalt, Mark T 366693Agent - Life3/5/2008 
ActiveKofalt, Mark T 366693Agent - Property3/25/2008 
InactivePetreccia, Vincent Henry 609275Agent - Casualty3/5/20081/15/2014
InactivePetreccia, Vincent Henry 609275Agent - Health3/5/20087/10/2013
InactivePetreccia, Vincent Henry 609275Agent - Life3/5/20087/10/2013
InactivePetreccia, Vincent Henry 609275Agent - Property3/5/20081/15/2014

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