Agency Information

PLAYER'S HEALTH COVER USA INC.

718 WASHINGTON AVENUE N, SUITE 402

MINNEAPOLIS, MN 55401

612-295-3185

compliance@playershealth.com

18885342

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	3461528	08/05/2019	Active	08/05/2019	08/31/2025
Non-Res. Surplus Lines Broker	3520886	02/11/2020	Active	02/11/2020	02/28/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	08/05/2019	Active	08/05/2019
Health	08/05/2019	Active	08/05/2019
Life	07/25/2022	Active	07/25/2022
Property	08/05/2019	Active	08/05/2019
Surplus Lines	02/11/2020	Active	02/11/2020

Company Name	Appointment Type	Status	Active Date
100311
AMTRUST INSURANCE COMPANY	Casualty	Active	09/18/2023
	Property	Active	09/18/2023
288
Company Name	Appointment Type	Status	Active Date
GREAT AMERICAN INSURANCE COMPANY	Health	Active	03/10/2020
1538
Company Name	Appointment Type	Status	Active Date
HMO COLORADO INC D/B/A HMO NEVADA	Health	Active	03/22/2024
100334
Company Name	Appointment Type	Status	Active Date
MILFORD CASUALTY INSURANCE COMPANY	Casualty	Active	09/18/2023
	Property	Active	09/18/2023
431
Company Name	Appointment Type	Status	Active Date
MUTUAL OF OMAHA INSURANCE COMPANY	Health	Active	03/30/2022
149264
Company Name	Appointment Type	Status	Active Date
NEXT INSURANCE US COMPANY	Casualty	Active	07/13/2022
	Property	Active	07/13/2022
1295
Company Name	Appointment Type	Status	Active Date
PHILADELPHIA INDEMNITY INSURANCE COMPANY	Casualty	Active	11/08/2019
	Property	Active	11/08/2019
1620
Company Name	Appointment Type	Status	Active Date
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE INC	Health	Active	03/22/2024
100333
Company Name	Appointment Type	Status	Active Date
SECURITY NATIONAL INSURANCE COMPANY	Casualty	Active	09/18/2023
	Property	Active	09/18/2023
1702
Company Name	Appointment Type	Status	Active Date
SEQUOIA INSURANCE COMPANY	Casualty	Active	09/18/2023
	Property	Active	09/18/2023
17636
Company Name	Appointment Type	Status	Active Date
TECHNOLOGY INSURANCE COMPANY INC	Casualty	Active	09/18/2023
	Property	Active	09/18/2023
1614
Company Name	Appointment Type	Status	Active Date
WESCO INSURANCE COMPANY	Casualty	Active	09/18/2023
	Property	Active	09/18/2023

row(s) 1 - 20 of 20

Name	Association Type	Agent	Begin Date	End Date
TYRRE ANDRE BURKS	Designated Resp Lic Prdcr	No	07/25/2022	-

1 - 1