Agency Information

PREMIER ADMINISTRATIVE SOLUTIONS INC

13600 ICOT BLVD BLDG A

CLEARWATER, FL 33760-3703

800-648-5174

http://www.premieradministrativesolutions.com

entitymanagement@chsamerica.com

2014636

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	3238546	04/27/2017	Active	04/27/2017	04/30/2026
Non-Res. Third Party Admin.	753919	05/10/2011	Active	05/10/2011	05/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Health	04/27/2017	Active	04/27/2017
Life	04/27/2017	Active	04/27/2017
TPA1 -Life/Health Insurance	05/10/2011	Active	05/10/2011

Name	Association Type	Agent	Begin Date	End Date
DALE FRANCIS SCHMIDT	Designated Resp Lic Prdcr	Yes	11/17/2020	-

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