DEPARTMENT OF INSURANCE

Affiliations

Name	Cohen, Jerrold Paul	DOIID	520587	NAIC NPN	399477

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	1/22/2001	6/30/2012
Inactive	Non Resident	Agent	Life	1/22/2001	6/30/2012
* 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	American Heritage Life Insurance Company	300272	Agent - Health	2/28/2006	6/23/2008
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	2/28/2006	6/23/2008
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Health	2/21/2003	4/7/2009
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Life	2/21/2003	4/7/2009
Inactive	Combined Insurance Company of America	301472	Agent - Health	11/22/2004	2/21/2006
Inactive	Combined Insurance Company of America	301472	Agent - Life	11/22/2004	2/21/2006
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/28/2010	6/30/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/28/2010	6/30/2012
Inactive	Humana Insurance Company	301104	Agent - Health	10/28/2010	6/30/2012
Inactive	Humana Insurance Company	301104	Agent - Life	10/28/2010	6/30/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/28/2010	6/30/2012
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/28/2010	6/30/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Health	10/28/2010	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	10/28/2010	2/23/2012
Inactive	Kanawha Insurance Company	300127	Agent - Health	5/12/2005	6/30/2012
Inactive	Kanawha Insurance Company	300127	Agent - Life	5/12/2005	6/30/2012
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/4/2011	1/24/2012
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	2/2/2004	6/30/2012
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	2/2/2004	6/30/2012
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	2/12/2003	11/9/2009
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	2/12/2003	11/9/2009
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Health	5/29/2003	6/25/2008
Inactive	ReliaStar Life Insurance Company of New York	301018	Agent - Life	5/29/2003	6/25/2008
Inactive	Trustmark Insurance Company	300317	Agent - Health	6/12/2005	5/20/2009
Inactive	Trustmark Insurance Company	300317	Agent - Life	6/12/2005	5/20/2009
Inactive	UNUM Life Insurance Company of America	300817	Agent - Health	2/2/2004	6/30/2012
Inactive	UNUM Life Insurance Company of America	300817	Agent - Life	2/2/2004	6/30/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	5/4/2011	1/24/2012
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	5/4/2011	1/24/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	The Farmington Company	534046	Agent - Life	1/5/2004	6/30/2012
Inactive	The Farmington Company	534046	Agent - Health	1/5/2004	6/30/2012