DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Medicare Complete	DOIID	1342029	NAIC NPN	20468236

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	5/24/2024		3/31/2026
Active	Non Resident	Agent	Health	5/24/2024		3/31/2026
* 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
Active	Aetna Health Inc. (PA)	660717	Agent - Health	8/3/2024
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	8/3/2024
Active	Aetna Life Insurance Company	301140	Agent - Health	8/3/2024
Active	SilverScript Insurance Company	663526	Agent - Health	8/3/2024
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	9/23/2024
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	9/23/2024

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	David, Jeremiah Alan	913330	Agent - Health	5/24/2024
Active	David, Jeremiah Alan	913330	Agent - Life	5/24/2024