DEPARTMENT OF INSURANCE
Affiliations
NameClement, Jerome FDOIID539314NAIC NPN407624
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentLife12/20/2017 12/31/2024
ActiveNon ResidentAgentHealth12/20/2017 12/31/2024
ActiveNon ResidentAgentVariable Life and Variable Annuities12/20/2017 12/31/2024
* 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.

License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent10/15/202412/31/2024   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAllianz Life Insurance Company of North America301791Agent - Life5/13/2021 
ActiveAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities5/13/2021 
InactiveAmerican Enterprise Life Insurance Company300262Agent - Life10/12/20041/24/2005
InactiveAmerican Enterprise Life Insurance Company300262Agent - Variable Life and Variable Annuities10/12/20041/24/2005
ActiveAmerican General Life Insurance Company301585Agent - Health2/5/2021 
ActiveAmerican General Life Insurance Company301585Agent - Life2/5/2021 
ActiveAmerican General Life Insurance Company301585Agent - Variable Life and Variable Annuities2/5/2021 
ActiveBanner Life Insurance Company301696Agent - Life8/8/2018 
InactiveBrighthouse Life Insurance Company301829Agent - Health12/10/201810/10/2023
InactiveBrighthouse Life Insurance Company301829Agent - Life12/10/201810/10/2023
InactiveBrighthouse Life Insurance Company301829Agent - Variable Life and Variable Annuities12/10/201810/10/2023
InactiveC.M. Life Insurance Company301335Agent - Health1/15/20034/26/2006
InactiveC.M. Life Insurance Company301335Agent - Life1/15/20034/26/2006
InactiveC.M. Life Insurance Company301335Agent - Variable Life and Variable Annuities1/15/20034/26/2006
InactiveCMFG Life Insurance Company300929Agent - Health3/5/20212/6/2024
InactiveCMFG Life Insurance Company300929Agent - Life3/5/20212/6/2024
InactiveCMFG Life Insurance Company300929Agent - Variable Life and Variable Annuities3/5/20212/6/2024
InactiveDelaware Life Insurance Company301256Agent - Health12/31/200312/31/2006
InactiveDelaware Life Insurance Company301256Agent - Life12/31/200311/29/2006
InactiveDelaware Life Insurance Company301256Agent - Variable Life and Variable Annuities12/31/200311/29/2006
InactiveEmpower Annuity Insurance Company300168Agent - Life11/10/201512/31/2016
InactiveEmpower Annuity Insurance Company300168Agent - Variable Life and Variable Annuities11/10/201512/31/2016
InactiveEquitable Financial Life Insurance Company300808Agent - Health9/4/201212/31/2016
InactiveEquitable Financial Life Insurance Company300808Agent - Life9/4/201212/31/2016
InactiveFortitude Life Insurance & Annuity Company301503Agent - Life3/3/201512/31/2016
InactiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities3/3/201512/31/2016
InactiveGenworth Life Insurance Company300623Agent - Health12/6/20022/10/2005
InactiveGenworth Life Insurance Company300623Agent - Life12/6/20022/10/2005
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health12/6/20022/15/2005
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life12/6/20022/15/2005
InactiveGenworth Life and Annuity Insurance Company301276Agent - Variable Life and Variable Annuities12/6/20022/15/2005
InactiveGuardian Insurance & Annuity Company Inc. (The)301920Agent - Life12/23/20021/26/2005
InactiveGuardian Insurance & Annuity Company Inc. (The)301920Agent - Variable Life and Variable Annuities12/23/20021/26/2005
InactiveKeyport Life Insurance Company300319Agent - Health10/9/200112/31/2003
InactiveKeyport Life Insurance Company300319Agent - Life10/9/200112/31/2003
InactiveKeyport Life Insurance Company300319Agent - Variable Life and Variable Annuities10/9/200112/31/2003
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Health1/15/20034/26/2006
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Life1/15/20034/26/2006
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Variable Life and Variable Annuities1/15/20034/26/2006
InactiveMetLife Investors USA Insurance Company300845Agent - Health10/20/20045/4/2005
InactiveMetLife Investors USA Insurance Company300845Agent - Life10/20/20045/4/2005
InactiveMetLife Investors USA Insurance Company300845Agent - Variable Life and Variable Annuities10/20/20045/4/2005
InactiveMetropolitan Life Insurance Company301948Agent - Health10/20/20045/4/2005
InactiveMetropolitan Life Insurance Company301948Agent - Life10/20/20045/4/2005
InactiveMetropolitan Life Insurance Company301948Agent - Variable Life and Variable Annuities10/20/20045/4/2005
InactiveNew York Life Insurance and Annuity Corporation300726Agent - Life8/11/20032/18/2005
InactiveNew York Life Insurance and Annuity Corporation300726Agent - Variable Life and Variable Annuities8/11/20032/18/2005
InactivePacific Life Insurance Company301848Agent - Life11/21/20147/25/2016
InactivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities11/21/20147/25/2016
InactivePenn Insurance and Annuity Company300712Agent - Life4/3/20153/7/2016
InactivePenn Mutual Life Insurance Company301394Agent - Life4/3/20153/7/2016
InactiveProvident Life and Accident Insurance Company301525Agent - Health1/7/200312/31/2006
InactiveProvident Life and Accident Insurance Company301525Agent - Life1/7/200312/31/2006
InactivePruco Life Insurance Company300954Agent - Life3/3/201512/22/2016
InactivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities3/3/201512/22/2016
InactivePrudential Insurance Company of America300784Agent - Life11/10/201512/31/2016
InactivePrudential Insurance Company of America300784Agent - Variable Life and Variable Annuities11/10/201512/31/2016
InactiveTransamerica Life Insurance Company300571Agent - Life6/5/20196/6/2024
InactiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities3/10/20152/19/2016
InactiveTransamerica Life Insurance and Annuity Company300148Agent - Life12/13/20042/21/2005
InactiveTransamerica Occidental Life Insurance Company300966Agent - Life12/13/20042/21/2005
InactiveUNUM Life Insurance Company of America300817Agent - Health1/7/200312/31/2006
InactiveUNUM Life Insurance Company of America300817Agent - Life1/7/200312/31/2006
InactiveWestern National Life Insurance Company300461Agent - Life6/19/20022/2/2005
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBanc of America Insurance Services, Inc.400875Agent - Health10/28/20042/11/2005
InactiveBanc of America Insurance Services, Inc.400875Agent - Life10/28/20042/11/2005
InactiveBanc of America Insurance Services, Inc.400875Agent - Variable Life and Variable Annuities10/28/20042/11/2005
InactiveBanc of America Investment Service, Inc.583248Agent - Health10/28/20042/8/2005
InactiveBanc of America Investment Service, Inc.583248Agent - Life10/28/20042/8/2005
InactiveBanc of America Investment Service, Inc.583248Agent - Variable Life and Variable Annuities10/28/20042/8/2005
DeniedCabot Lodge Securities, LLC1085353Agent - Health  
InactiveCabot Lodge Securities, LLC1085353Agent - Life10/20/20219/27/2023
InactiveCabot Lodge Securities, LLC1085353Agent - Variable Life and Variable Annuities10/20/20219/27/2023
ActivePKS Financial Services, Inc.586503Agent - Health3/5/2019 
ActivePKS Financial Services, Inc.586503Agent - Life8/8/2018 
ActivePurshe Kaplan Sterling Investments Inc586493Agent - Health3/5/2019 
ActivePurshe Kaplan Sterling Investments Inc586493Agent - Life3/5/2019 
ActivePurshe Kaplan Sterling Investments Inc586493Agent - Variable Life and Variable Annuities3/5/2019 
InactiveQuick & Reilly400526Agent - Health7/29/20025/31/2005
InactiveQuick & Reilly400526Agent - Life7/29/20025/31/2005
InactiveQuick & Reilly400526Agent - Variable Life and Variable Annuities7/29/20025/31/2005
InactiveWentworth Financial Partners LLC813940Agent - Health2/9/20218/2/2023
InactiveWentworth Financial Partners LLC813940Agent - Life2/9/20218/2/2023

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