DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Bush, Jerry Clyde	DOIID	865839	NAIC NPN	17478536

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	1/21/2015		10/31/2025
Active	Resident	Agent	Property	2/24/2015		10/31/2025
Active	Resident	Agent	Casualty	3/17/2015		10/31/2025
Active	Resident	Agent	Life	1/21/2015		10/31/2025
* 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	08/15/2025	10/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Baptist Health Plan, Inc.	300157	Agent - Health	9/25/2015	3/31/2019
Inactive	Erie Family Life Insurance Company	301400	Agent - Life	5/5/2015	7/30/2021
Inactive	Erie Insurance Company	300230	Agent - Casualty	5/5/2015	7/30/2021
Inactive	Erie Insurance Company	300230	Agent - Property	5/5/2015	7/30/2021
Inactive	Erie Insurance Company of New York	789916	Agent - Casualty	9/25/2015	7/30/2021
Inactive	Erie Insurance Company of New York	789916	Agent - Property	9/25/2015	7/30/2021
Inactive	Erie Insurance Exchange	300789	Agent - Casualty	5/5/2015	7/30/2021
Inactive	Erie Insurance Exchange	300789	Agent - Property	5/5/2015	7/30/2021
Inactive	Erie Insurance Property & Casualty Company	789942	Agent - Casualty	9/25/2015	7/30/2021
Inactive	Erie Insurance Property & Casualty Company	789942	Agent - Property	9/25/2015	7/30/2021
Inactive	Flagship City Insurance Company	789965	Agent - Casualty	9/25/2015	7/30/2021
Inactive	Flagship City Insurance Company	789965	Agent - Property	9/25/2015	7/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	James H Moore And Son Holdings LLC	852564	Agent - Health	2/25/2016	3/31/2019
Inactive	James H Moore And Son Holdings LLC	852564	Agent - Life	2/25/2016	3/31/2020
Inactive	James H Moore And Son Holdings LLC	852564	Agent - Property	2/25/2016	3/31/2020
Inactive	James H Moore And Son Holdings LLC	852564	Agent - Casualty	2/25/2016	3/31/2020