DEPARTMENT OF INSURANCE

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		3/31/2025
Active	Non Resident	Agent	Life	10/22/2019		3/31/2025
* 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	01/15/2025	03/31/2025

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	2/20/2020
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	6/15/2021
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
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	6/15/2021
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	6/15/2021
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	10/6/2023
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/6/2023

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