DEPARTMENT OF INSURANCE

Affiliations

Name	Jacobsen, David	DOIID	1262627	NAIC NPN	19993339

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	6/5/2026		2/28/2029
Active	Non Resident	Agent	Property	6/5/2026		2/28/2029
Inactive	Non Resident	Agent	Health	3/16/2023	2/28/2025
* 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	3/20/2023	2/28/2025
Inactive	Aetna Health of Ohio Inc.	1065035	Agent - Health	3/20/2023	2/28/2025
Inactive	Aetna Life Insurance Company	301140	Agent - Health	3/20/2023	2/28/2025
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/16/2023	8/12/2024
Inactive	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	3/16/2023	8/12/2024
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	3/16/2023	8/12/2024
Active	Bristol West Insurance Company	301655	Agent - Casualty	6/7/2026
Active	Bristol West Insurance Company	301655	Agent - Property	6/7/2026
Inactive	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	3/16/2023	8/2/2024
Inactive	CareSource Kentucky Co.	838179	Agent - Health	10/24/2023	10/25/2023
Inactive	Compcare Health Services Insurance Corporation	948751	Agent - Health	3/16/2023	8/12/2024
Active	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Casualty	6/7/2026
Active	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Property	6/7/2026
Active	Farmers Insurance Exchange	300336	Agent - Casualty	6/7/2026
Active	Farmers Insurance Exchange	300336	Agent - Property	6/7/2026
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	6/7/2026
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Property	6/7/2026
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/7/2026
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/7/2026
Active	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	6/7/2026
Active	Foremost Property and Casualty Insurance Company	300871	Agent - Property	6/7/2026
Inactive	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	4/11/2023	2/28/2025
Inactive	SilverScript Insurance Company	663526	Agent - Health	3/20/2023	2/28/2025
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/16/2023	8/2/2024
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	3/16/2023	8/2/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Fx Insurance Agency, LLC	646184	Agent - Casualty	6/17/2026
Active	Fx Insurance Agency, LLC	646184	Agent - Property	6/17/2026
Inactive	eHealthInsurance Services Inc.	514105	Agent - Health	4/3/2023	8/5/2024