DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Sheryl	DOIID	684336	NAIC NPN	11059499

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	12/3/2020		11/30/2025
Active	Non Resident	Agent	Property	12/3/2020		11/30/2025
Inactive	Non Resident	Agent	Life	6/16/2017	11/30/2019
Inactive	Non Resident	Agent	Health	9/17/2017	11/30/2019
* 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	09/15/2025	11/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	21st Century North America Insurance Company	300884	Agent - Casualty	7/2/2014	12/16/2015
Inactive	21st Century North America Insurance Company	300884	Agent - Property	7/2/2014	12/16/2015
Inactive	Allstate Indemnity Company	300778	Agent - Casualty	3/11/2021	11/15/2024
Inactive	Allstate Indemnity Company	300778	Agent - Property	3/11/2021	11/15/2024
Inactive	Allstate Insurance Company	300773	Agent - Casualty	3/11/2021	11/15/2024
Inactive	Allstate Insurance Company	300773	Agent - Property	3/11/2021	11/15/2024
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	3/11/2021	11/15/2024
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Property	3/11/2021	11/15/2024
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Casualty	3/11/2021	11/15/2024
Inactive	Allstate Vehicle & Property Insurance Company	301429	Agent - Property	3/11/2021	11/15/2024
Inactive	American Economy Insurance Company	300315	Agent - Casualty	6/28/2022	11/5/2024
Inactive	American Economy Insurance Company	300315	Agent - Property	6/28/2022	11/5/2024
Inactive	American Strategic Insurance Corp	883540	Agent - Casualty	5/5/2021	6/15/2025
Inactive	American Strategic Insurance Corp	883540	Agent - Property	5/5/2021	6/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Health	5/4/2018	11/30/2019
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/4/2018	11/30/2019
Active	Bristol West Insurance Company	301655	Agent - Casualty	5/3/2025
Active	Bristol West Insurance Company	301655	Agent - Property	5/3/2025
Inactive	Esurance Insurance Company	301072	Agent - Casualty	6/26/2014	7/1/2016
Inactive	Esurance Insurance Company	301072	Agent - Property	6/26/2014	7/1/2016
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Casualty	8/18/2021	2/12/2025
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Property	8/18/2021	2/12/2025
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	8/18/2021	2/12/2025
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	8/18/2021	2/12/2025
Inactive	Federal Insurance Company	301144	Agent - Health	4/19/2018	11/30/2019
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	5/3/2025
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	5/3/2025
Active	GEICO Marine Insurance Company	590512	Agent - Casualty	6/17/2025
Active	GEICO Marine Insurance Company	590512	Agent - Property	6/17/2025
Inactive	Golden Rule Insurance Company	301943	Agent - Health	2/22/2018	12/3/2019
Inactive	Golden Rule Insurance Company	301943	Agent - Life	2/22/2018	12/3/2019
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/29/2017	3/27/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/29/2017	3/27/2018
Inactive	Humana Insurance Company	301104	Agent - Health	9/29/2017	3/27/2018
Inactive	Humana Insurance Company	301104	Agent - Life	9/29/2017	3/27/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/29/2017	3/27/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/29/2017	3/27/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/29/2017	3/27/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	9/29/2017	3/27/2018
Inactive	Independence American Insurance Company	524747	Agent - Health	5/21/2018	12/11/2019
Inactive	Permanent General Assurance Corporation of Ohio	709250	Agent - Casualty	7/8/2014	6/1/2017
Active	Root Insurance Company	964834	Agent - Casualty	3/17/2025
Active	Root Insurance Company	964834	Agent - Property	3/17/2025
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	7/7/2014	7/19/2017
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	7/7/2014	7/19/2017
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	7/7/2014	7/19/2017
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	7/7/2014	7/19/2017
Inactive	Travelers Personal Insurance Company	705785	Agent - Casualty	7/19/2021	2/10/2025
Inactive	Travelers Personal Insurance Company	705785	Agent - Property	7/19/2021	2/10/2025
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	6/20/2017	2/12/2019
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/7/2018	12/11/2018
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	10/7/2018	12/11/2018
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	10/7/2018	12/11/2018
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	10/7/2018	12/11/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	5/4/2018	11/30/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Health	5/4/2018	11/30/2019
Inactive	General Automobile Ins Services Inc	706632	Agent - Casualty	12/21/2016	7/19/2017
Inactive	Policygenius LLC	874468	Agent - Property	8/25/2021	11/11/2024
Inactive	Policygenius LLC	874468	Agent - Casualty	8/25/2021	11/11/2024
Active	Savvy Insurance Agency, LLC	1245246	Agent - Property	3/7/2025
Active	Savvy Insurance Agency, LLC	1245246	Agent - Casualty	3/7/2025
Active	Savvy Insurance Solutions, LLC	1069167	Agent - Property	3/7/2025
Active	Savvy Insurance Solutions, LLC	1069167	Agent - Casualty	3/7/2025
Denied	TZ Insurance Solutions LLC	727470	Agent - Property
Denied	TZ Insurance Solutions LLC	727470	Agent - Casualty
Inactive	TZ Insurance Solutions LLC	727470	Agent - Life	12/5/2017	4/16/2018
Inactive	TZ Insurance Solutions LLC	727470	Agent - Health	12/5/2017	4/16/2018