black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

TIC INC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN70905
Status:
First Licensure:
07/05/2000
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
701 SAND LAKE RD
ONALASKA, WI 54650-2442
Mailing:
701 SAND LAKE RD
ONALASKA, WI 54650-2442
Phone:
+1 (608) 783-6441
Fax:
+1 (608) 783-2181
Email:
rsantos@ticinsurance.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 07/05/2000 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
AETNA HEALTH INC
12/02/2024 HMD45749
AETNA LIFE INSURANCE COMPANY
12/02/2024 LHF621
AMERICAN HERITAGE LIFE INSURANCE COMPANY
07/05/2000 LHF594 01/18/2006
AMERICAN PROGRESSIVE LIFE & HEALTH INS COMPANY OF NEW YORK
02/07/2023 LHF374
AMTRUST INSURANCE COMPANY
01/24/2023 PCF260762 04/15/2025
ARCH INSURANCE COMPANY
08/26/2022 PCF62719
FEDERAL INSURANCE COMPANY
02/16/2023 PCF439 02/04/2025
HUMANA INSURANCE COMPANY
03/26/2012 LHF980 05/04/2015
HUMANADENTAL INSURANCE COMPANY
03/26/2012 LHF173873 05/04/2015
MAINE DENTAL SERVICE CORP
11/15/2024 NPD29330
MIDDLESEX INSURANCE COMPANY
02/15/2023 PCF509
RED TREE INSURANCE COMPANY INC
11/15/2024 LHF174438
SECURITY NATIONAL INSURANCE COMPANY
01/24/2023 PCF189490 04/15/2025
SENTRY INSURANCE COMPANY
02/15/2023 PCF461
SEQUOIA INSURANCE COMPANY
01/24/2023 PCF128467 04/15/2025
STANDARD INSURANCE COMPANY
11/20/2024 LHF991 04/03/2025
TECHNOLOGY INSURANCE COMPANY INC
01/24/2023 PCF136874 04/15/2025
WELLCARE OF MAINE, INC.
02/07/2023 HMD305081
WELLCARE PRESCRIPTION INSURANCE INC
02/07/2023 LHF121869
WESCO INSURANCE COMPANY
01/24/2023 PCF49735 04/15/2025

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
TIMOTHY MICHAEL JOHNSON
03/16/2005 PRN111672

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
TIMOTHY MICHAEL JOHNSON PRN111672

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
654419

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 05/14/2025 12:42:02 AM