DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Zogg, Jack Leonard	DOIID	352085	NAIC NPN	139889

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	10/13/1998	7/31/2007
Inactive	Non Resident	Agent	Health Maintenance Organization	10/13/1998	3/1/2001
Inactive	Non Resident	Agent	Health	10/13/1998	7/31/2007
* 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	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	7/31/2007
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	10/13/1998	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	10/13/1998	7/31/2007
Inactive	Humana Insurance Company	301104	Agent - Life	10/13/1998	7/31/2007

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Stanton Group, LLC	562283	Agent - Life	12/20/2002	7/31/2007
Inactive	Stanton Group, LLC	562283	Agent - Health	12/20/2002	7/31/2007