DEPARTMENT OF INSURANCE

Affiliations

Name	Goergen, George Thomas	DOIID	389255	NAIC NPN	2117323

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	5/7/1985	10/31/2015
Inactive	Non Resident	Agent	Health	5/7/1985	10/31/2015
* 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	Aetna Life Insurance Company	301140	Agent - Health	5/7/1985	3/31/1997
Inactive	Aetna Life Insurance Company	301140	Agent - Life	5/7/1985	3/31/1997
Inactive	American General Assurance Company	300586	Agent - Health	2/6/2010	7/25/2011
Inactive	American General Assurance Company	300586	Agent - Life	2/6/2010	7/25/2011
Inactive	American Retirement Life Insurance Company	706303	Agent - Health	12/10/2013	12/18/2014
Inactive	American Retirement Life Insurance Company	706303	Agent - Life	12/10/2013	12/18/2014
Inactive	Anthem Life Insurance Company	301209	Agent - Health	2/2/2004	12/13/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	2/2/2004	12/13/2015
Inactive	Athene Annuity and Life Company	301893	Agent - Life	5/14/2010	9/6/2012
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	6/24/2008	4/13/2015
Inactive	CompBenefits Insurance Company	301864	Agent - Health	6/24/2008	11/28/2011
Inactive	CompBenefits Insurance Company	301864	Agent - Life	6/24/2008	11/28/2011
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	9/25/2009	9/11/2013
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	4/13/2015
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	11/24/2008	10/31/2015
Inactive	Genworth Life Insurance Company	300623	Agent - Health	10/5/2005	12/4/2007
Inactive	Genworth Life Insurance Company	300623	Agent - Life	10/5/2005	12/4/2007
Inactive	Gerber Life Insurance Company	300529	Agent - Health	7/28/2011	12/26/2012
Inactive	Gerber Life Insurance Company	300529	Agent - Life	7/28/2011	12/26/2012
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	4/13/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2012	4/13/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/16/2005	4/13/2015
Inactive	Humana Insurance Company	301104	Agent - Health	12/16/2005	4/13/2015
Inactive	Humana Insurance Company	301104	Agent - Life	12/16/2005	4/13/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/16/2005	4/13/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/16/2005	4/13/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	4/13/2015
Inactive	HumanaDental Insurance Company	301457	Agent - Health	6/24/2008	2/24/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	6/24/2008	2/24/2012
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	6/11/2004	6/7/2008
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	6/11/2004	6/7/2008
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/10/2008	4/13/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/10/2008	4/13/2015
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	10/19/2005	11/26/2009
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	10/19/2005	11/26/2009
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/24/2006	12/26/2012
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Health	6/1/2004	9/21/2005
Inactive	Nassau Life Insurance Company of Kansas	300667	Agent - Life	6/1/2004	9/21/2005
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	7/24/2011	11/4/2011
Inactive	SilverScript Insurance Company	663526	Agent - Health	10/28/2009	10/31/2015
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Health	8/26/2009	10/31/2015
Inactive	Standard Security Life Insurance Company of NY	301487	Agent - Life	8/26/2009	10/31/2015
Inactive	Time Insurance Company	300683	Agent - Health	7/28/2009	10/7/2010
Inactive	Time Insurance Company	300683	Agent - Life	7/28/2009	10/7/2010
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Health	2/6/2010	8/11/2011
Inactive	United States Life Insurance Company in the City of New York	301126	Agent - Life	2/6/2010	8/11/2011
Inactive	United World Life Insurance Company	300532	Agent - Health	5/24/2006	12/15/2010
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	5/24/2006	12/26/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	5/24/2006	12/26/2012
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/24/2011	10/31/2015
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	7/24/2011	10/31/2015
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/11/2015	10/31/2015
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Health	5/24/2004	10/31/2015
Inactive	Wellpoint Life and Health Insurance Company	300469	Agent - Life	5/24/2004	10/31/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	1/29/2004	6/23/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	1/29/2004	6/23/2008
Inactive	Designated Agent Company Inc.	681257	Agent - Life	6/28/2008	12/13/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	6/28/2008	12/13/2015