DEPARTMENT OF INSURANCE

Affiliations

Name	Kemmons Wilson Insurance Group LLC	DOIID	838854	NAIC NPN	17218920

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	2/7/2019	3/31/2026
Active	Non Resident	Agent	Casualty	4/20/2018	3/31/2026
Active	Non Resident	Agent	Property	4/20/2018	3/31/2026
Active	Non Resident	Agent	Life	2/7/2019	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
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	AIG Property Casualty Company	300621	Agent - Casualty	9/26/2016	2/1/2017
Inactive	AIG Property Casualty Company	300621	Agent - Property	9/26/2016	2/1/2017
Active	AMCO Insurance Company	300204	Agent - Casualty	8/17/2018
Active	AMCO Insurance Company	300204	Agent - Property	8/17/2018
Active	All Savers Insurance Company	301940	Agent - Health	4/25/2024
Active	All Savers Insurance Company	301940	Agent - Life	4/25/2024
Active	Allied Insurance Company of America	793586	Agent - Casualty	8/17/2018
Active	Allied Insurance Company of America	793586	Agent - Property	8/17/2018
Active	Allied Property and Casualty Insurance Company	300279	Agent - Casualty	8/17/2018
Active	Allied Property and Casualty Insurance Company	300279	Agent - Property	8/17/2018
Active	AmTrust Insurance Company	300179	Agent - Casualty	6/11/2018
Active	AmTrust Insurance Company	300179	Agent - Property	6/11/2018
Active	American Bankers Insurance Company of Florida	300360	Agent - Casualty	11/7/2018
Active	American Bankers Insurance Company of Florida	300360	Agent - Property	11/7/2018
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	5/31/2016	2/1/2017
Inactive	American Fire and Casualty Company	300567	Agent - Property	5/31/2016	2/1/2017
Active	Auto-Owners Insurance Company	301480	Agent - Casualty	11/14/2019
Active	Auto-Owners Insurance Company	301480	Agent - Property	11/14/2019
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	7/28/2014	12/14/2016
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	7/28/2014	12/14/2016
Active	ClearPath Insurance Company	979815	Agent - Casualty	4/26/2018
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	5/31/2016	2/1/2017
Inactive	Consolidated Insurance Company	300943	Agent - Property	5/31/2016	2/1/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	2/22/2021	12/12/2024
Active	Depositors Insurance Company	301634	Agent - Casualty	8/17/2018
Active	Depositors Insurance Company	301634	Agent - Property	8/17/2018
Active	Employers Assurance Company	300120	Agent - Casualty	5/13/2024
Active	Employers Compensation Insurance Company	797885	Agent - Casualty	5/13/2024
Active	Employers Preferred Insurance Company	520656	Agent - Casualty	5/13/2024
Inactive	Farmington Casualty Company	301137	Agent - Casualty	7/28/2014	2/1/2017
Inactive	Farmington Casualty Company	301137	Agent - Property	7/28/2014	2/1/2017
Inactive	Federal Insurance Company	301144	Agent - Casualty	2/20/2019	9/27/2023
Inactive	Federal Insurance Company	301144	Agent - Property	2/20/2019	9/27/2023
Active	General Casualty Company of Wisconsin	300930	Agent - Casualty	4/28/2020
Active	General Casualty Company of Wisconsin	300930	Agent - Property	4/28/2020
Active	Grange Indemnity Insurance Company	300793	Agent - Casualty	6/11/2019
Active	Grange Indemnity Insurance Company	300793	Agent - Property	6/11/2019
Active	Grange Insurance Company	300234	Agent - Casualty	6/11/2019
Active	Grange Insurance Company	300234	Agent - Property	6/11/2019
Active	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	6/11/2019
Active	Grange Property & Casualty Insurance Company	601680	Agent - Property	6/11/2019
Active	Harleysville Insurance Company	301462	Agent - Property	3/23/2021
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	2/22/2021	12/12/2024
Inactive	Humana Insurance Company	301104	Agent - Health	2/22/2021	12/12/2024
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	2/22/2021	12/12/2024
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	2/22/2021	12/12/2024
Inactive	Indiana Insurance Company	301909	Agent - Casualty	5/31/2016	2/1/2017
Inactive	Indiana Insurance Company	301909	Agent - Property	5/31/2016	2/1/2017
Inactive	Key Risk Insurance Company	630687	Agent - Casualty	2/24/2020	8/31/2020
Inactive	Key Risk Insurance Company	630687	Agent - Property	2/24/2020	8/31/2020
Inactive	Liberty Insurance Underwriters Inc.	301391	Agent - Casualty	3/19/2015	2/1/2017
Inactive	Liberty Insurance Underwriters Inc.	301391	Agent - Property	3/19/2015	2/1/2017
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	6/11/2018
Active	Milford Casualty Insurance Company	301460	Agent - Property	6/11/2018
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Casualty	1/4/2019	6/9/2025
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Property	1/4/2019	6/9/2025
Active	Nationwide Agribusiness Insurance Company	301008	Agent - Casualty	8/17/2018
Active	Nationwide Agribusiness Insurance Company	301008	Agent - Property	8/17/2018
Active	Nationwide Assurance Company	300166	Agent - Casualty	3/4/2020
Active	Nationwide General Insurance Company	300603	Agent - Casualty	8/28/2019
Active	Nationwide General Insurance Company	300603	Agent - Property	8/28/2019
Active	Nationwide Insurance Company of America	300333	Agent - Casualty	8/28/2019
Active	Nationwide Insurance Company of America	300333	Agent - Property	8/28/2019
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	8/17/2018
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	8/17/2018
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	2/2/2022
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	2/2/2022
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	5/31/2016	2/1/2017
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	5/31/2016	2/1/2017
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	11/5/2018
Active	Ohio Casualty Insurance Company	301492	Agent - Property	11/5/2018
Active	Ohio Security Insurance Company	300622	Agent - Casualty	8/31/2018
Active	Ohio Security Insurance Company	300622	Agent - Property	8/31/2018
Active	Owners Insurance Company	300796	Agent - Casualty	5/26/2021
Active	Owners Insurance Company	300796	Agent - Property	5/26/2021
Inactive	Park National Insurance Company	692514	Agent - Casualty	6/11/2018	7/15/2024
Inactive	Park National Insurance Company	692514	Agent - Property	6/11/2018	7/15/2024
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	5/31/2016	2/1/2017
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	5/31/2016	2/1/2017
Inactive	Peerless Insurance Company	301910	Agent - Casualty	5/31/2016	2/1/2017
Inactive	Peerless Insurance Company	301910	Agent - Property	5/31/2016	2/1/2017
Active	Philadelphia Indemnity Insurance Company	301221	Agent - Casualty	5/11/2022
Active	Philadelphia Indemnity Insurance Company	301221	Agent - Property	5/11/2022
Active	Regent Insurance Company	300411	Agent - Casualty	4/28/2020
Active	Regent Insurance Company	300411	Agent - Property	4/28/2020
Active	Reliance Standard Life Insurance Company	300584	Agent - Health	5/1/2019
Active	Reliance Standard Life Insurance Company	300584	Agent - Life	5/1/2019
Active	Security National Insurance Company	301151	Agent - Casualty	6/11/2018
Active	Security National Insurance Company	301151	Agent - Property	6/11/2018
Active	Sentinel Insurance Company, Limited	501696	Agent - Casualty	5/16/2018
Active	Sentinel Insurance Company, Limited	501696	Agent - Property	5/16/2018
Active	Sequoia Insurance Company	628046	Agent - Casualty	5/5/2020
Active	Sequoia Insurance Company	628046	Agent - Property	5/5/2020
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	1/23/2017	2/1/2017
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	1/23/2017	2/1/2017
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Casualty	1/23/2017	2/1/2017
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Property	1/23/2017	2/1/2017
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Casualty	1/23/2017	2/1/2017
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Property	1/23/2017	2/1/2017
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	1/23/2017	2/1/2017
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	1/23/2017	2/1/2017
Inactive	StarNet Insurance Company	502746	Agent - Casualty	3/20/2020	8/31/2020
Inactive	StarNet Insurance Company	502746	Agent - Property	3/20/2020	8/31/2020
Active	Starr Indemnity and Liability Company	301685	Agent - Casualty	2/11/2020
Active	Starr Indemnity and Liability Company	301685	Agent - Health	2/11/2020
Active	Starr Indemnity and Liability Company	301685	Agent - Property	2/11/2020
Active	Technology Insurance Company	613278	Agent - Casualty	6/11/2018
Active	Technology Insurance Company	613278	Agent - Property	6/11/2018
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	1/23/2017	2/1/2017
Inactive	The Phoenix Insurance Company	301502	Agent - Property	1/23/2017	2/1/2017
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	7/28/2014	2/1/2017
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	7/28/2014	2/1/2017
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	7/28/2014	2/1/2017
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	7/28/2014	2/1/2017
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Casualty	7/28/2014	2/1/2017
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Property	7/28/2014	2/1/2017
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	1/23/2017	2/1/2017
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	1/23/2017	2/1/2017
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	1/23/2017	2/1/2017
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	1/23/2017	2/1/2017
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	1/23/2017	2/1/2017
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	1/23/2017	2/1/2017
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	1/23/2017	2/1/2017
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	1/23/2017	2/1/2017
Active	Trustgard Insurance Company	300104	Agent - Casualty	6/11/2019
Active	Trustgard Insurance Company	300104	Agent - Property	6/11/2019
Active	Twin City Fire Insurance Company	300721	Agent - Casualty	5/14/2018
Active	Twin City Fire Insurance Company	300721	Agent - Property	5/14/2018
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	2/13/2019	12/17/2024
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	2/13/2019	12/17/2024
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	2/13/2019	12/17/2024
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Life	2/13/2019	12/17/2024
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	2/13/2019	12/17/2024
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Life	2/13/2019	12/17/2024
Active	Wesco Insurance Company	300534	Agent - Casualty	6/11/2018
Active	Wesco Insurance Company	300534	Agent - Property	6/11/2018
Inactive	West American Insurance Company	301112	Agent - Casualty	5/31/2016	2/1/2017
Inactive	West American Insurance Company	301112	Agent - Property	5/31/2016	2/1/2017

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Floyd, Michael Edward	611312	Agent - Casualty	4/22/2014	11/30/2016
Inactive	Floyd, Michael Edward	611312	Agent - Property	4/22/2014	11/30/2016
Active	Gray, Andrew W	980653	Agent - Casualty	1/13/2025
Active	Gray, Andrew W	980653	Agent - Property	1/13/2025
Inactive	Klatt, Cynthia H	1121659	Agent - Casualty	5/26/2021	1/13/2025
Inactive	Klatt, Cynthia H	1121659	Agent - Property	5/26/2021	1/13/2025
Pending Replacement	Rogers, Christopher Wayne	994000	Agent - Health	2/7/2019
Pending Replacement	Rogers, Christopher Wayne	994000	Agent - Life	2/7/2019
Inactive	Thomas, Dave	914423	Agent - Casualty	4/20/2018	1/31/2022
Inactive	Thomas, Dave	914423	Agent - Property	4/20/2018	1/31/2022