DEPARTMENT OF INSURANCE

Affiliations

Name	Jensen, Dale I	DOIID	542643	NAIC NPN	3316159

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	4/27/2006	7/31/2020
Inactive	Non Resident	Agent	Health	12/12/2001	7/31/2020
Inactive	Non Resident	Agent	Casualty	4/27/2006	7/31/2020
Inactive	Non Resident	Agent	Life	12/12/2001	7/31/2020
* 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	CompBenefits Dental, Inc.	591692	Agent - Health	4/11/2012	12/5/2014
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	4/11/2012	12/5/2014
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	2/11/2009	12/17/2014
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	2/11/2009	12/17/2014
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	5/29/2011	12/23/2015
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	5/29/2011	12/23/2015
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	1/13/2003	12/11/2009
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	1/13/2003	12/11/2009
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	5/4/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	8/1/2013	5/4/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	4/11/2012	5/4/2015
Inactive	Humana Insurance Company	301104	Agent - Health	8/1/2013	5/4/2015
Inactive	Humana Insurance Company	301104	Agent - Life	8/1/2013	5/4/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	4/11/2012	5/4/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	4/11/2012	5/4/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	5/4/2015
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	6/15/2018
Inactive	Kanawha Insurance Company	300127	Agent - Health	4/11/2012	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	4/11/2012	12/5/2014
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	12/12/2001	7/31/2020
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	12/12/2001	7/31/2020
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Casualty	7/10/2014	7/31/2020
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Property	7/10/2014	7/31/2020
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	10/26/2009	12/17/2014
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	10/26/2009	12/17/2014
Inactive	Time Insurance Company	300683	Agent - Health	2/11/2002	9/11/2002
Inactive	Time Insurance Company	300683	Agent - Life	2/11/2002	9/11/2002

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	12/16/2013	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	12/16/2013	11/2/2016
Inactive	Primecor Inc	697140	Agent - Life	1/13/2009	1/15/2019
Inactive	Primecor Inc	697140	Agent - Health	1/13/2009	1/15/2019
Inactive	Primecor Inc	697140	Agent - Property	2/11/2009	1/15/2019
Inactive	Primecor Inc	697140	Agent - Casualty	2/11/2009	1/15/2019