DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Legacy Insurance Advisors Inc	DOIID	1062153	NAIC NPN	15977938

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/22/2019		3/31/2027
Active	Non Resident	Agent	Life	10/22/2019		3/31/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Life	6/10/2020	12/19/2025
Active	Aetna Health Inc. (PA)	660717	Agent - Health	2/20/2020
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	6/15/2021	12/19/2025
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/6/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	2/20/2020
Active	Aetna Life Insurance Company	301140	Agent - Life	2/20/2020
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	6/15/2021	12/19/2025
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	6/15/2021	12/19/2025
Active	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	9/25/2025
Active	Lafayette Life Insurance Company (The)	301039	Agent - Health	10/22/2019
Active	Lafayette Life Insurance Company (The)	301039	Agent - Life	10/22/2019
Inactive	Lasso Healthcare Insurance Company	1022651	Agent - Health	7/6/2023	12/22/2023
Active	SilverScript Insurance Company	663526	Agent - Health	1/17/2020
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	1/31/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	1/31/2022	12/22/2022
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	1/31/2022
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	9/26/2025
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	9/26/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Van Valkenburg, Jason	1043691	Agent - Health	10/22/2019
Active	Van Valkenburg, Jason	1043691	Agent - Life	10/22/2019