DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bender, Jack Michael	DOIID	525169	NAIC NPN	2492401

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	8/14/2008	8/31/2017
Inactive	Non Resident	Agent	Health	8/14/2008	8/31/2017
* 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 Health Inc.	300694	Agent - Health	6/4/2001	5/24/2004
Inactive	Aetna Life Insurance Company	301140	Agent - Health	4/24/2001	5/24/2004
Inactive	Aetna Life Insurance Company	301140	Agent - Life	4/24/2001	5/24/2004
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/30/2015	12/13/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/30/2015	12/13/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/30/2015	12/3/2015
Inactive	Humana Insurance Company	301104	Agent - Health	9/30/2015	12/30/2016
Inactive	Humana Insurance Company	301104	Agent - Life	9/30/2015	12/13/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/30/2015	12/30/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/30/2015	12/13/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/30/2015	11/3/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/30/2015	10/22/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	11/27/2012	9/3/2013
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	11/27/2012	9/3/2013