DEPARTMENT OF INSURANCE

Affiliations

Name	Jackson, Cleveland	DOIID	1053943	NAIC NPN	18939340

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	8/29/2019	12/18/2023
Inactive	Non Resident	Agent	Life	8/29/2019	12/18/2023
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	10/19/2021	12/18/2023
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	10/19/2021	12/18/2023
Inactive	Aetna Life Insurance Company	301140	Agent - Health	10/19/2021	12/18/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	4/14/2020	5/18/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	5/8/2020	5/18/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/31/2019	11/23/2020
Inactive	CompBenefits Insurance Company	301864	Agent - Health	12/16/2019	11/23/2020
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/16/2019	11/23/2020
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	12/16/2019	11/23/2020
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	12/16/2019	11/23/2020
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/16/2019	11/23/2020
Inactive	Humana Insurance Company	301104	Agent - Health	12/16/2019	11/23/2020
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/16/2019	11/23/2020
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/16/2019	11/23/2020
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	12/16/2019	11/23/2020
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	12/16/2019	11/23/2020
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/19/2021	12/18/2023
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/22/2020	5/18/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	3/22/2020	5/18/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/22/2020	12/23/2021
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	3/22/2020	5/18/2022
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	7/25/2023	3/4/2024
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/18/2019	11/30/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	9/19/2019	5/18/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	9/19/2019	5/18/2021