DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Long, Jeremy	DOIID	1110106	NAIC NPN	18336865

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	11/20/2023		2/28/2027
Active	Non Resident	Agent	Health	11/20/2023		2/28/2027
* 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	Colonial Life and Accident Insurance Company	300846	Agent - Health	4/19/2022	2/28/2023
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	4/19/2022	2/28/2023
Active	Markel Insurance Company	301475	Agent - Health	1/16/2024
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	1/4/2023	2/28/2023
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	1/4/2023	2/28/2023
Inactive	Starmount Life Insurance Company	628031	Agent - Health	1/4/2023	2/28/2023
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	1/4/2023	2/28/2023
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	1/4/2023	2/28/2023
Inactive	Unum Insurance Company	301499	Agent - Health	1/4/2023	2/28/2023
Inactive	Unum Insurance Company	301499	Agent - Life	1/4/2023	2/28/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Gallagher Benefit Services Inc	525782	Agent - Life
Active	Gallagher Benefit Services Inc	525782	Agent - Health	1/16/2024