DEPARTMENT OF INSURANCE
Affiliations
NameCouch, Jeremy ChadDOIID520864NAIC NPN4801718
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveResidentAgentLife1/8/2018 10/31/2025
ActiveResidentAgentVariable Life and Variable Annuities1/8/2018 10/31/2025
InactiveResidentAgentHealth9/30/200210/28/2009 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveEverlake Life Insurance Company300873Agent - Life3/1/20055/22/2006
InactiveEverlake Life Insurance Company300873Agent - Variable Life and Variable Annuities3/1/20055/22/2006
InactiveFirst Penn-Pacific Life Insurance Company301581Agent - Health3/26/20017/1/2002
InactiveFirst Penn-Pacific Life Insurance Company301581Agent - Life3/26/20017/1/2002
InactiveJackson National Life Insurance Company300486Agent - Life2/27/20065/24/2006
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities2/27/20065/24/2006
InactiveJefferson National Life Insurance Company300258Agent - Life11/15/201111/1/2017
InactiveJefferson National Life Insurance Company300258Agent - Variable Life and Variable Annuities11/15/201111/1/2017
InactiveLincoln Benefit Life Company301110Agent - Health9/13/20017/1/2002
InactiveLincoln Benefit Life Company301110Agent - Life9/13/20017/1/2002
InactiveLincoln Benefit Life Company301110Agent - Variable Life and Variable Annuities9/13/20017/1/2002
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities3/21/20017/1/2002
InactiveNationwide Life Insurance Company300495Agent - Health9/23/200810/13/2009
InactiveNationwide Life Insurance Company300495Agent - Life9/23/200810/13/2009
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities9/23/200810/13/2009
InactiveNationwide Life and Annuity Insurance Company300714Agent - Life9/23/200810/13/2009
InactiveNationwide Life and Annuity Insurance Company300714Agent - Variable Life and Variable Annuities9/23/200810/13/2009
ActivePacific Life Insurance Company301848Agent - Life9/15/2021 
ActivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities9/15/2021 
InactiveProvident Life and Accident Insurance Company301525Agent - Health8/14/20017/1/2002
InactiveProvident Life and Accident Insurance Company301525Agent - Life8/14/20017/1/2002
InactiveRiverSource Life Insurance Company301952Agent - Health2/6/20017/1/2002
InactiveRiverSource Life Insurance Company301952Agent - Life3/20/20017/1/2002
InactiveTalcott Resolution Life Insurance Company301759Agent - Health2/23/200610/1/2007
InactiveTalcott Resolution Life Insurance Company301759Agent - Life2/23/200610/1/2007
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities2/23/200610/1/2007
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Health2/23/200610/1/2007
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life2/23/200610/1/2007
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities2/23/200610/1/2007
InactiveUNUM Life Insurance Company of America300817Agent - Health8/14/20017/1/2002
InactiveUNUM Life Insurance Company of America300817Agent - Life8/14/20017/1/2002
InactiveVenerable Insurance and Annuity Company301006Agent - Life12/16/20049/15/2005
InactiveVenerable Insurance and Annuity Company301006Agent - Variable Life and Variable Annuities12/16/20049/15/2005
InactiveWestern National Life Insurance Company300461Agent - Life10/10/20029/9/2005
InactiveWestern-Southern Life Assurance Company301590Agent - Health12/28/20055/22/2006
InactiveWestern-Southern Life Assurance Company301590Agent - Life12/28/20055/22/2006
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveB B & T Investment Services Inc.510955Agent - Health9/23/20089/10/2009
InactiveB B & T Investment Services Inc.510955Agent - Life9/23/20089/10/2009
InactiveB B & T Investment Services Inc.510955Agent - Variable Life and Variable Annuities9/23/20089/10/2009
InactiveBB&T Investment Services Inc707567Agent - Health7/16/20099/10/2009
InactiveBB&T Investment Services Inc707567Agent - Life7/16/20099/10/2009
InactiveBB&T Investment Services Inc707567Agent - Variable Life and Variable Annuities7/16/20099/10/2009
InactiveFifth Third Insurance Agency Inc399341Agent - Life4/27/20042/27/2007
InactiveFifth Third Insurance Agency Inc399341Agent - Variable Life and Variable Annuities4/27/20042/27/2007

© Commonwealth of Kentucky. All rights reserved.