DEPARTMENT OF INSURANCE
Affiliations
NameGoldberg, Jack DOIID308808NAIC NPN1441565
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAgentVariable Life and Variable Annuities10/6/20067/31/2009 
InactiveResidentAgentHealth12/4/20097/31/2011 
InactiveResidentAgentHealth Maintenance Organization9/21/19843/1/2001 
InactiveResidentAgentLife12/4/20097/31/2011 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAetna Life Insurance Company301140Agent - Health5/31/197210/24/2002
InactiveAetna Life Insurance Company301140Agent - Life5/31/197210/24/2002
InactiveAmerican Bankers Life Assurance Company of Florida300171Agent - Health2/24/199412/16/1996
InactiveAmerican Bankers Life Assurance Company of Florida300171Agent - Life2/24/199412/16/1996
InactiveAmerican National Insurance Company301861Agent - Health3/3/20107/31/2011
InactiveAnnuity Investors Life Insurance Company300715Agent - Life3/29/20109/13/2011
InactiveAnthem Life Insurance Company301209Agent - Health9/27/19937/1/2006
InactiveAnthem Life Insurance Company301209Agent - Life9/27/19937/1/2006
InactiveCitizens Security Life Insurance Company301257Agent - Health3/9/20047/1/2006
InactiveCitizens Security Life Insurance Company301257Agent - Life3/9/20047/1/2006
InactiveClarendon National Insurance Company300843Agent - Health9/20/20003/26/2004
InactiveCompBenefits Dental, Inc.591692Agent - Health7/9/20107/31/2011
InactiveCompanion Life Insurance Company300191Agent - Health10/15/20015/7/2003
InactiveCompanion Life Insurance Company300191Agent - Life10/15/20015/7/2003
InactiveContinental Casualty Company301019Agent - Health12/1/199911/29/2004
InactiveDental Concern Inc. (The)301641Agent - Health8/13/20107/31/2011
InactiveEmpower Annuity Insurance Company of America300259Agent - Health12/20/199311/7/2003
InactiveEmpower Annuity Insurance Company of America300259Agent - Life12/20/199311/7/2003
InactiveFirst Colony Life Insurance Company301179Agent - Health12/3/20017/19/2004
InactiveFirst Colony Life Insurance Company301179Agent - Life12/3/20017/19/2004
InactiveGenworth Life Insurance Company300623Agent - Health2/8/20107/31/2011
InactiveGenworth Life Insurance Company300623Agent - Life2/8/20107/31/2011
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health9/22/20087/31/2009
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life9/22/20087/31/2009
InactiveGenworth Life and Annuity Insurance Company301276Agent - Variable Life and Variable Annuities9/22/20087/31/2009
InactiveGerber Life Insurance Company300529Agent - Health12/5/19972/23/2001
InactiveGerber Life Insurance Company300529Agent - Life12/5/19972/23/2001
InactiveGreat Southern Life Insurance Company301443Agent - Health12/31/19794/24/2002
InactiveGreat Southern Life Insurance Company301443Agent - Life12/31/19796/24/2002
InactiveHumana Health Plan, Inc.300142Agent - Health8/13/20107/31/2011
InactiveHumana Health Plan, Inc.300142Agent - Health Maintenance Organization9/21/19843/1/2001
InactiveHumana Insurance Company301104Agent - Health8/13/20107/31/2011
InactiveHumana Insurance Company301104Agent - Life8/13/20107/31/2011
InactiveHumana Insurance Company of Kentucky300826Agent - Health8/13/20107/31/2011
InactiveHumana Insurance Company of Kentucky300826Agent - Life8/13/20107/31/2011
InactiveHumanaDental Insurance Company301457Agent - Health8/13/20107/31/2011
InactiveHumanaDental Insurance Company301457Agent - Life8/13/20107/31/2011
InactiveIllinois Mutual Life Insurance Company301479Agent - Health10/20/19927/31/2001
InactiveIllinois Mutual Life Insurance Company301479Agent - Life10/20/19927/31/2001
InactiveJohn Alden Life Insurance Company300573Agent - Health11/10/20037/1/2006
InactiveJohn Alden Life Insurance Company300573Agent - Life11/10/20037/1/2006
InactiveJohn Hancock Life Insurance Company300821Agent - Health3/7/20077/31/2009
InactiveJohn Hancock Life Insurance Company300821Agent - Life3/7/20077/31/2009
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Health2/8/20107/31/2011
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life2/8/20107/31/2011
InactiveKanawha Insurance Company300127Agent - Health8/13/20107/31/2011
InactiveKanawha Insurance Company300127Agent - Life8/13/20107/31/2011
InactiveKentucky Home Life Insurance Company300477Agent - Health12/1/199812/30/2004
InactiveKentucky Home Life Insurance Company300477Agent - Life12/1/199812/30/2004
InactiveLafayette Life Insurance Company (The)301039Agent - Health8/28/20007/1/2006
InactiveLafayette Life Insurance Company (The)301039Agent - Life8/28/20007/1/2006
InactiveLife Insurance Company of the Southwest301867Agent - Health2/18/20109/7/2010
InactiveLife Insurance Company of the Southwest301867Agent - Life2/18/20109/7/2010
InactiveLoyal American Life Insurance Company301172Agent - Life3/29/20109/20/2010
InactiveMassMutual Ascend Life Insurance Company300320Agent - Life3/29/20107/31/2011
InactiveMetropolitan Life Insurance Company301948Agent - Health6/10/19978/31/2004
InactiveMetropolitan Life Insurance Company301948Agent - Life6/10/19978/31/2004
InactiveMidland Life Insurance Company (The)300310Agent - Health10/13/19953/31/1997
InactiveMidland Life Insurance Company (The)300310Agent - Life10/13/19953/31/1997
InactiveMidland National Life Insurance Company300923Agent - Health3/6/20078/22/2007
InactiveMidland National Life Insurance Company300923Agent - Life3/6/20078/22/2007
InactiveMidland National Life Insurance Company300923Agent - Variable Life and Variable Annuities8/12/20027/1/2006
InactiveNassau Life Insurance Company301406Agent - Health8/3/198912/31/1998
InactiveNassau Life Insurance Company301406Agent - Life8/3/198912/31/1998
InactiveNational Guardian Life Insurance Company300596Agent - Health5/3/20047/5/2005
InactiveNational Guardian Life Insurance Company300596Agent - Life5/3/20047/5/2005
InactiveNew England Life Insurance Company300343Agent - Health4/16/19978/31/2004
InactiveNew England Life Insurance Company300343Agent - Life4/16/19978/31/2004
InactiveNorth American Company for Life and Health Insurance300291Agent - Life3/26/20107/31/2011
InactiveOld Line Life Insurance Company of America (The)301709Agent - Life3/17/19974/17/2000
InactivePeoples Benefit Life Insurance Company301895Agent - Health7/23/19977/1/2006
InactivePeoples Benefit Life Insurance Company301895Agent - Life7/23/19977/1/2006
InactivePrincipal Life Insurance Company300129Agent - Health6/6/19857/1/2006
InactivePrincipal Life Insurance Company300129Agent - Life6/6/19857/1/2006
InactiveProtective Life Insurance Company300638Agent - Health5/14/199812/15/2003
InactiveProtective Life Insurance Company300638Agent - Life5/14/199812/15/2003
InactiveReassure America Life Insurance Company301902Agent - Health5/2/20001/3/2003
InactiveReassure America Life Insurance Company301902Agent - Life5/2/20001/3/2003
InactiveSecurity Life Insurance Company of America300936Agent - Health5/8/200012/6/2002
InactiveSecurity Life Insurance Company of America300936Agent - Life5/8/200012/6/2002
InactiveSun Life Assurance Company of Canada301811Agent - Health11/27/20007/1/2006
InactiveSun Life Assurance Company of Canada301811Agent - Life11/27/20007/1/2006
InactiveSymetra Life Insurance Company301691Agent - Health3/28/19956/25/2001
InactiveSymetra Life Insurance Company301691Agent - Life3/28/19956/25/2001
InactiveTalcott Resolution Life Insurance Company301759Agent - Health2/12/19827/1/2006
InactiveTalcott Resolution Life Insurance Company301759Agent - Life2/12/19827/1/2006
InactiveTime Insurance Company300683Agent - Health8/30/198312/10/2004
InactiveTime Insurance Company300683Agent - Life8/30/198312/10/2004
InactiveTransamerica Life Insurance Company300571Agent - Health2/25/20107/31/2011
InactiveTransamerica Life Insurance Company300571Agent - Life2/25/20107/31/2011
InactiveU.S. Financial Life Insurance Company301812Agent - Health6/8/20004/11/2003
InactiveU.S. Financial Life Insurance Company301812Agent - Life6/15/200011/7/2002
InactiveUnion Security Insurance Company301844Agent - Health12/12/199412/31/2000
InactiveUnion Security Insurance Company301844Agent - Life12/12/199412/31/2000
InactiveUnited of Omaha Life Insurance Company300156Agent - Health5/18/20107/31/2011
InactiveUnited of Omaha Life Insurance Company300156Agent - Life5/18/20107/31/2011
InactiveUnitedHealthcare Insurance Company300946Agent - Health10/12/200111/21/2005
InactiveUnitedHealthcare Insurance Company300946Agent - Life10/12/200111/21/2005
InactiveUnitedHealthcare Life Insurance Company301517Agent - Health10/16/19953/31/1997
InactiveUnitedHealthcare Life Insurance Company301517Agent - Life10/16/19953/31/1997
InactiveVenerable Insurance and Annuity Company301006Agent - Health6/22/20077/31/2009
InactiveVenerable Insurance and Annuity Company301006Agent - Life6/22/20077/31/2009
InactiveVenerable Insurance and Annuity Company301006Agent - Variable Life and Variable Annuities6/22/20077/31/2009
InactiveVoya Retirement Insurance and Annuity Company300643Agent - Health3/6/200712/17/2008
InactiveVoya Retirement Insurance and Annuity Company300643Agent - Life3/6/200712/17/2008
InactiveVoya Retirement Insurance and Annuity Company300643Agent - Variable Life and Variable Annuities3/6/200712/17/2008
InactiveWoodmen Accident and Life Company300147Agent - Health8/21/19966/28/2000
InactiveWoodmen Accident and Life Company300147Agent - Life8/21/19966/28/2000
InactiveWorld Insurance Company300396Agent - Health10/16/19901/3/1997
InactiveWorld Insurance Company300396Agent - Life10/16/19901/3/1997
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveArison Insurance Services, Inc.401001Agent - Life1/29/20012/28/2003
InactiveArison Insurance Services, Inc.401001Agent - Health1/29/20012/28/2003
InactiveHealthplan Services, Inc.401230Agent - Health8/31/19953/31/1997
InactiveMedlink Inc400721Agent - Life2/4/20047/1/2006
InactiveMedlink Inc400721Agent - Health2/4/20047/1/2006
InactiveProfessional Insurance Marketers Inc.400645Agent - Life4/26/19835/31/2003
InactiveProfessional Insurance Marketers Inc.400645Agent - Health4/26/19835/31/2003
InactiveProfessional Insurance Marketers Inc.400645Agent - Health Maintenance Organization10/15/19853/1/2001

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