DEPARTMENT OF INSURANCE
Affiliations
NameWillis, Jeremy DwanDOIID389349NAIC NPN7208635
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveResidentAgentLife1/29/2014 12/31/2025
ActiveResidentAgentCasualty4/29/2014 12/31/2025
ActiveResidentAgentHealth4/30/2014 12/31/2025
ActiveResidentAgentProperty4/29/2014 12/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent10/15/202512/31/2025   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAccendo Insurance Company300312Agent - Life5/17/2025 
ActiveAetna Health and Life Insurance Company300523Agent - Health11/30/2018 
InactiveAmerican Continental Insurance Company643130Agent - Life11/30/20188/11/2021
InactiveAmerican Economy Insurance Company300315Agent - Casualty11/9/20195/27/2022
InactiveAmerican Economy Insurance Company300315Agent - Property11/9/20195/27/2022
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Health11/29/20185/2/2019
InactiveAmerican Family Life Assurance Company of Columbus (AFLAC)301781Agent - Life11/29/20185/2/2019
ActiveAmerican Modern Property and Casualty Insurance Company301954Agent - Casualty7/29/2019 
ActiveAmerican Modern Property and Casualty Insurance Company301954Agent - Property7/29/2019 
InactiveAmerican Modern Select Insurance Company581481Agent - Casualty9/18/201411/14/2021
InactiveAmerican Modern Select Insurance Company581481Agent - Property9/18/201411/14/2021
InactiveAmerican National General Insurance Company301944Agent - Casualty6/2/20146/2/2015
InactiveAmerican National General Insurance Company301944Agent - Property6/2/20146/2/2015
ActiveAmerican National Insurance Company301861Agent - Life4/24/2025 
InactiveAmerican National Property and Casualty Company300392Agent - Casualty6/2/20146/2/2015
InactiveAmerican National Property and Casualty Company300392Agent - Property6/2/20146/2/2015
InactiveAmerican Southern Home Insurance Company626276Agent - Casualty9/18/201411/14/2021
InactiveAmerican Southern Home Insurance Company626276Agent - Property9/18/201411/14/2021
InactiveAmerico Financial Life and Annuity Insurance Company300869Agent - Life1/12/201810/1/2019
InactiveAmeritas Life Insurance Corporation300126Agent - Health11/7/202211/13/2023
InactiveAmeritas Life Insurance Corporation300126Agent - Life11/7/202211/13/2023
ActiveAnthem Health Plans of Kentucky, Inc.300999Agent - Health4/21/2025 
ActiveAnthem Insurance Companies, Inc.300941Agent - Health4/21/2025 
InactiveAnthem Life Insurance Company301209Agent - Health7/8/201712/16/2024
InactiveAnthem Life Insurance Company301209Agent - Life7/8/201712/16/2024
ActiveBanner Life Insurance Company301696Agent - Life4/25/2023 
InactiveBristol West Insurance Company301655Agent - Casualty11/14/201812/20/2024
InactiveBristol West Insurance Company301655Agent - Property11/14/201812/20/2024
ActiveColonial Life and Accident Insurance Company300846Agent - Health5/13/2025 
ActiveColonial Life and Accident Insurance Company300846Agent - Life5/13/2025 
InactiveColumbian Life Insurance Company300810Agent - Life7/6/201710/14/2022
InactiveCompBenefits Dental, Inc.591692Agent - Health12/22/20158/11/2016
ActiveCompcare Health Services Insurance Corporation948751Agent - Health4/21/2025 
ActiveContinental Life Insurance Company of Brentwood Tennessee301526Agent - Health11/30/2018 
InactiveDental Concern Inc. (The)301641Agent - Health12/22/20158/11/2016
InactiveEncompass Indemnity Company546376Agent - Casualty3/1/201810/3/2024
InactiveEncompass Indemnity Company546376Agent - Property3/1/201810/3/2024
InactiveEncompass Insurance Company of America556578Agent - Casualty3/1/201812/13/2018
InactiveEncompass Insurance Company of America556578Agent - Property3/1/201812/13/2018
ActiveFidelity & Guaranty Life Insurance Company301359Agent - Life5/15/2025 
ActiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Casualty2/5/2018 
ActiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Property2/5/2018 
InactiveGolden Rule Insurance Company301943Agent - Health11/12/201812/13/2020
InactiveGolden Rule Insurance Company301943Agent - Life11/12/201812/15/2020
ActiveGrange Indemnity Insurance Company300793Agent - Casualty2/2/2018 
ActiveGrange Indemnity Insurance Company300793Agent - Property2/2/2018 
ActiveGrange Insurance Company300234Agent - Casualty2/2/2018 
ActiveGrange Insurance Company300234Agent - Property2/2/2018 
InactiveGrange Life Insurance Company300128Agent - Health4/16/20183/31/2021
InactiveGrange Life Insurance Company300128Agent - Life4/16/20183/31/2021
ActiveGrange Property & Casualty Insurance Company601680Agent - Casualty2/2/2018 
ActiveGrange Property & Casualty Insurance Company601680Agent - Property2/2/2018 
InactiveHumana Benefit Plan of Illinois, Inc.781543Agent - Health10/17/201412/8/2015
InactiveHumana Health Plan of Ohio Inc.301565Agent - Health10/17/201412/8/2015
InactiveHumana Health Plan, Inc.300142Agent - Health12/22/20158/11/2016
InactiveHumana Insurance Company301104Agent - Health10/17/20148/11/2016
InactiveHumana Insurance Company301104Agent - Life10/17/20148/11/2016
InactiveHumana Insurance Company of Kentucky300826Agent - Health10/17/201412/8/2015
InactiveHumana Insurance Company of Kentucky300826Agent - Life10/17/201412/8/2015
InactiveHumana Medical Plan, Inc.801568Agent - Health10/17/201412/8/2015
InactiveIndependent Order of Foresters300743Agent - Life2/18/201412/29/2021
ActiveIntegon Indemnity Corporation300674Agent - Casualty7/22/2022 
ActiveIntegon Indemnity Corporation300674Agent - Property7/22/2022 
InactiveKanawha Insurance Company300127Agent - Health10/17/201411/3/2015
InactiveKanawha Insurance Company300127Agent - Life10/17/201411/3/2015
ActiveLiberty Bankers Life Insurance Company542461Agent - Life8/22/2022 
ActiveLifeShield National Insurance Company737111Agent - Health6/19/2025 
ActiveLifeShield National Insurance Company737111Agent - Life6/19/2025 
ActiveMilbank Insurance Company925185Agent - Casualty7/14/2020 
ActiveMilbank Insurance Company925185Agent - Property7/14/2020 
InactiveModern Woodmen of America301213Agent - Life7/16/20184/10/2019
ActiveNationwide Life and Annuity Insurance Company300714Agent - Health6/4/2025 
ActiveNationwide Life and Annuity Insurance Company300714Agent - Life6/4/2025 
InactiveOhio Casualty Insurance Company301492Agent - Casualty2/8/20185/27/2022
InactiveOhio Casualty Insurance Company301492Agent - Property2/8/20185/27/2022
InactivePhysicians Life Insurance Company300924Agent - Health8/17/20232/1/2024
InactivePhysicians Life Insurance Company300924Agent - Life8/17/20232/1/2024
InactivePhysicians Mutual Insurance Company, Inc.301084Agent - Health8/17/20232/1/2024
ActivePruco Life Insurance Company300954Agent - Life5/13/2025 
InactiveReserve National Insurance Company301073Agent - Life2/11/20148/20/2014
ActiveRoot Insurance Company964834Agent - Casualty2/12/2025 
ActiveRoot Insurance Company964834Agent - Property2/12/2025 
InactiveSAFECO Insurance Company of America300159Agent - Casualty6/4/20153/29/2024
InactiveSAFECO Insurance Company of America300159Agent - Property6/4/20153/29/2024
InactiveSAFECO Insurance Company of Illinois301350Agent - Casualty6/4/20155/27/2022
InactiveSAFECO Insurance Company of Illinois301350Agent - Property6/4/20155/27/2022
InactiveSagicor Life Insurance Company300459Agent - Life3/21/20196/2/2020
InactiveSelective Insurance Company of America500018Agent - Casualty3/8/201812/22/2020
InactiveSelective Insurance Company of America500018Agent - Property3/8/201812/22/2020
InactiveSelective Insurance Company of South Carolina500012Agent - Casualty3/8/201812/22/2020
InactiveSelective Insurance Company of South Carolina500012Agent - Property3/8/201812/22/2020
InactiveSelective Insurance Company of the Southeast300381Agent - Casualty3/8/201812/22/2020
InactiveSelective Insurance Company of the Southeast300381Agent - Property3/8/201812/22/2020
ActiveState Automobile Mutual Insurance Company301824Agent - Casualty3/6/2020 
ActiveState Automobile Mutual Insurance Company301824Agent - Property3/6/2020 
ActiveThe Savings Bank Mutual Life Insurance Company of Massachusetts690290Agent - Life5/28/2025 
ActiveTier One Insurance Company301056Agent - Health10/24/2022 
ActiveTier One Insurance Company301056Agent - Life8/24/2022 
InactiveTime Insurance Company300683Agent - Health9/15/20149/25/2016
InactiveTime Insurance Company300683Agent - Life9/15/20149/25/2016
InactiveTransamerica Life Insurance Company300571Agent - Health1/8/20182/11/2019
InactiveTransamerica Life Insurance Company300571Agent - Life1/8/20182/11/2019
InactiveTransamerica Premier Life Insurance Company300558Agent - Health8/2/201611/13/2017
InactiveTransamerica Premier Life Insurance Company300558Agent - Life2/5/20143/23/2016
ActiveTrexis Insurance Corporation599902Agent - Casualty5/9/2019 
ActiveTrexis One Insurance Corporation684197Agent - Casualty5/9/2019 
ActiveTrustgard Insurance Company300104Agent - Casualty2/2/2018 
ActiveTrustgard Insurance Company300104Agent - Property2/2/2018 
InactiveUnited Financial Casualty Company301886Agent - Casualty9/22/20147/9/2015
InactiveUnited Financial Casualty Company301886Agent - Property9/22/20147/9/2015
ActiveUnited Home Life Insurance Company300421Agent - Life5/13/2025 
InactiveUnited States Fire Insurance Company582240Agent - Health8/19/202212/27/2023
InactiveUnited of Omaha Life Insurance Company300156Agent - Health10/7/202011/23/2020
InactiveUnited of Omaha Life Insurance Company300156Agent - Life10/7/202011/23/2020
InactiveUnitedHealthcare Insurance Company300946Agent - Health10/24/20183/1/2024
InactiveUnitedHealthcare Insurance Company300946Agent - Life10/24/20183/1/2024
InactiveUnitedHealthcare of Kentucky, Ltd.301337Agent - Health10/24/20183/1/2024
InactiveUnitedHealthcare of Ohio, Inc.300493Agent - Health10/24/20183/1/2024
InactiveUnitrin Auto and Home Insurance Company301538Agent - Casualty2/16/201810/23/2024
InactiveUnitrin Auto and Home Insurance Company301538Agent - Property2/16/201810/23/2024
InactiveUtica Mutual Insurance Company301933Agent - Casualty1/30/201811/21/2018
InactiveUtica Mutual Insurance Company301933Agent - Property1/30/201811/21/2018
InactiveVictoria Fire & Casualty Company300313Agent - Casualty5/27/20159/14/2017
InactiveVictoria Fire & Casualty Company300313Agent - Property5/27/20159/14/2017
ActiveWest Bend Insurance Company672974Agent - Casualty1/26/2018 
ActiveWest Bend Insurance Company672974Agent - Property1/26/2018 
DeniedWoodmen of the World Life Insurance Society301446Agent - Health  
InactiveWoodmen of the World Life Insurance Society301446Agent - Life6/7/20065/30/2007
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveDental Choice Agency Inc.398085Agent - Health12/11/2018 
InactiveDesignated Agent Company Inc.681257Agent - Life7/10/20172/11/2025
InactiveDesignated Agent Company Inc.681257Agent - Health7/10/20172/11/2025
ActiveFirefly Agency LLC663796Agent - Life1/26/2018 
ActiveFirefly Agency LLC663796Agent - Health1/26/2018 
ActiveFirefly Agency LLC663796Agent - Property1/26/2018 
ActiveFirefly Agency LLC663796Agent - Casualty1/26/2018 
ActiveMWAGIA, Inc549166Agent - Life11/29/2018 
ActiveMWAGIA, Inc549166Agent - Health11/29/2018 
InactiveThe Willis Agency878064Agent - Life5/14/20153/31/2021
InactiveThe Willis Agency878064Agent - Health5/14/20153/31/2021
InactiveThe Willis Agency878064Agent - Property5/14/20153/31/2021
InactiveThe Willis Agency878064Agent - Casualty5/14/20153/31/2021

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