DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bortnem, David	DOIID	1147348	NAIC NPN	19995039

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	7/27/2021		8/31/2026
Active	Non Resident	Agent	Life	7/27/2021		8/31/2026
* 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	06/15/2024	08/31/2024	06/06/2024	06/06/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Ameritas Life Insurance Corporation	300126	Agent - Health	8/26/2021
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	12/14/2021
Active	Fidelity Security Life Insurance Company	300466	Agent - Health	8/20/2021
Active	Fidelity Security Life Insurance Company	300466	Agent - Life	8/20/2021
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	7/11/2024
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	7/11/2024
Active	National Guardian Life Insurance Company	300596	Agent - Health	9/14/2021
Active	Nationwide Life Insurance Company	300495	Agent - Health	11/11/2022
Active	Nationwide Life Insurance Company	300495	Agent - Life	11/11/2022
Active	Renaissance Life & Health Insurance Company of America	301447	Agent - Health	9/14/2021
Active	Renaissance Life & Health Insurance Company of America	301447	Agent - Life	9/14/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Direct Benefits, An Alera Group Agency, Llc	1126744	Agent - Life	11/15/2021
Active	Direct Benefits, An Alera Group Agency, Llc	1126744	Agent - Health	11/15/2021