DEPARTMENT OF INSURANCE

Affiliations

Name	Simon, Jeffery D	DOIID	302571	NAIC NPN	1493554

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	8/3/1989	9/30/2004
Inactive	Non Resident	Agent	Life	8/3/1989	9/30/2004
* 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	American General Life Insurance Company	301585	Agent - Health	3/31/2003	9/30/2004
Inactive	American General Life Insurance Company	301585	Agent - Life	9/5/2002	9/30/2004
Inactive	American States Insurance Company	301230	Agent - Health	2/2/1990	5/28/1996
Inactive	American States Life Insurance Company	301884	Agent - Health	2/2/1990	4/25/1996
Inactive	American States Life Insurance Company	301884	Agent - Life	2/2/1990	4/25/1996
Inactive	Brighthouse Life Insurance Company	301829	Agent - Health	8/3/1989	5/20/1996
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	8/3/1989	5/20/1996
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	6/10/1997	11/7/2003
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Life	6/10/1997	11/7/2003
Inactive	Continental Casualty Company	301019	Agent - Health	3/1/1990	5/29/1996
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Health	7/17/1991	5/6/1996
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	7/17/1991	5/6/1996
Inactive	Golden Rule Insurance Company	301943	Agent - Health	9/20/1990	5/2/1996
Inactive	Golden Rule Insurance Company	301943	Agent - Life	9/20/1990	5/2/1996
Inactive	Humana Insurance Company	301104	Agent - Health	4/18/1990	4/26/1996
Inactive	Humana Insurance Company	301104	Agent - Life	4/18/1990	4/26/1996
Inactive	Jackson National Life Insurance Company	300486	Agent - Health	2/18/1997	6/20/2001
Inactive	Jackson National Life Insurance Company	300486	Agent - Life	2/18/1997	6/20/2001
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	2/9/1995	5/2/1996
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	2/9/1995	5/2/1996
Inactive	Manhattan National Life Insurance Company	301011	Agent - Health	5/30/1997	4/12/2001
Inactive	Manhattan National Life Insurance Company	301011	Agent - Life	5/30/1997	4/12/2001
Inactive	MassMutual Ascend Life Insurance Company	300320	Agent - Life	7/24/1995	4/26/1996
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Health	7/25/1995	5/20/1996
Inactive	MetLife Life and Annuity Company of Connecticut	301593	Agent - Life	7/25/1995	5/20/1996
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Health	3/21/2000	3/31/2003
Inactive	Old Line Life Insurance Company of America (The)	301709	Agent - Life	3/27/1997	3/31/2003
Inactive	Pacific Life Insurance Company	301848	Agent - Health	8/9/1996	9/30/2004
Inactive	Pacific Life Insurance Company	301848	Agent - Life	8/9/1996	9/30/2004
Inactive	Shenandoah Life Insurance Company	300130	Agent - Health	5/15/1992	4/29/1996
Inactive	Shenandoah Life Insurance Company	300130	Agent - Life	5/15/1992	4/29/1996
Inactive	Voya Retirement Insurance and Annuity Company	300643	Agent - Health	4/7/1993	5/6/1996
Inactive	Voya Retirement Insurance and Annuity Company	300643	Agent - Life	4/7/1993	5/6/1996

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Eastern Kentucky-Pikeville Inc.	398199	Agent - Health	8/24/1989	5/22/1996
Inactive	Acordia of Eastern Kentucky-Pikeville Inc.	398199	Agent - Life	8/24/1989	5/22/1996
Inactive	Healthplan Services, Inc.	401230	Agent - Health	8/31/1995	4/24/1996