DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Stack, Jacob	DOIID	1089744	NAIC NPN	19013002

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	7/17/2020	10/31/2024
* 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 - Health	9/10/2021	11/17/2023
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	7/22/2020	10/31/2024
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	12/11/2020	10/31/2024
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/22/2020	10/31/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	7/22/2020	10/31/2024
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	12/11/2020	10/31/2024
Inactive	SilverScript Insurance Company	663526	Agent - Health	7/22/2020	10/31/2024
Inactive	Tier One Insurance Company	301056	Agent - Health	5/26/2023	11/9/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	TZ Insurance Solutions LLC	727470	Agent - Health	5/24/2023	11/7/2023