DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jacobs, Todd William	DOIID	375510	NAIC NPN	1495195

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/23/2006	5/31/2013
Inactive	Non Resident	Agent	Health Maintenance Organization	10/30/1997	3/1/2001
Inactive	Non Resident	Agent	Life	8/23/2006	5/31/2013
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/1/2001	5/31/2005
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health Maintenance Organization	10/30/1997	3/1/2001
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	2/17/1998	5/31/2005
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/23/2006	5/31/2013
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/23/2006	5/31/2013
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2012	5/31/2013
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/10/2012	5/31/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia Senior of The Southeast Inc.	401297	Agent - Health	10/27/1997	2/10/2004
Inactive	Acordia Senior of The Southeast Inc.	401297	Agent - Life	10/27/1997	2/10/2004