DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Van Valkenburg, Jason	DOIID	1043691	NAIC NPN	9841767

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	6/12/2019		4/30/2026
Active	Non Resident	Agent	Life	6/12/2019		4/30/2026
* 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	02/15/2026	04/30/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	4/9/2021
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/6/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	4/9/2021
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	7/20/2021
Active	American General Life Insurance Company	301585	Agent - Health	7/24/2024
Active	American General Life Insurance Company	301585	Agent - Life	7/24/2024
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	7/20/2022
Active	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	9/26/2025
Active	Lafayette Life Insurance Company (The)	301039	Agent - Health	10/7/2019
Active	Lafayette Life Insurance Company (The)	301039	Agent - Life	10/7/2019
Active	SilverScript Insurance Company	663526	Agent - Health	6/14/2019
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	2/2/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	2/2/2022	12/22/2022
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	2/2/2022
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	10/21/2019	12/30/2021
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/21/2019	12/28/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Legacy Insurance Advisors Inc	1062153	Agent - Life	10/22/2019
Active	Legacy Insurance Advisors Inc	1062153	Agent - Health	10/22/2019
Active	TBS Agency, Inc.	502294	Agent - Life	5/15/2024
Active	TBS Agency, Inc.	502294	Agent - Health	5/15/2024