DEPARTMENT OF INSURANCE
Affiliations
NameCollins, Samuel JasonDOIID568253NAIC NPN7670582
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveResidentAgentVariable Life and Variable Annuities12/4/2012 10/31/2024
ActiveResidentAgentLife12/4/2012 10/31/2024
ActiveResidentAgentHealth12/4/2012 10/31/2024
* 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
Agent08/15/202410/31/2024   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAllianz Life Insurance Company of North America301791Agent - Life3/4/202112/13/2023
InactiveAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities3/4/202112/2/2023
InactiveAmerican General Life Insurance Company301585Agent - Health7/29/20191/15/2022
InactiveAmerican General Life Insurance Company301585Agent - Life7/29/20191/15/2022
InactiveAmerican General Life Insurance Company301585Agent - Variable Life and Variable Annuities7/29/20191/15/2022
ActiveBanner Life Insurance Company301696Agent - Life4/26/2021 
ActiveBrighthouse Life Insurance Company301829Agent - Health11/14/2014 
ActiveBrighthouse Life Insurance Company301829Agent - Life11/14/2014 
ActiveBrighthouse Life Insurance Company301829Agent - Variable Life and Variable Annuities11/14/2014 
InactiveEquitable Financial Life Insurance Company300808Agent - Life7/28/200911/7/2012
InactiveEquitable Financial Life Insurance Company300808Agent - Variable Life and Variable Annuities7/28/200911/7/2012
InactiveEquitable Financial Life Insurance Company of America301772Agent - Life5/21/20223/22/2023
InactiveEquitable Financial Life Insurance Company of America301772Agent - Variable Life and Variable Annuities5/21/20223/22/2023
ActiveForethought Life Insurance Company301407Agent - Health11/12/2015 
ActiveForethought Life Insurance Company301407Agent - Life11/12/2015 
ActiveForethought Life Insurance Company301407Agent - Variable Life and Variable Annuities11/12/2015 
InactiveFortitude Life Insurance & Annuity Company301503Agent - Life5/8/201412/22/2016
InactiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities5/8/201412/22/2016
InactiveGuardian Insurance & Annuity Company Inc. (The)301920Agent - Life11/13/201512/30/2020
InactiveGuardian Insurance & Annuity Company Inc. (The)301920Agent - Variable Life and Variable Annuities11/13/201512/30/2020
InactiveJackson National Life Insurance Company300486Agent - Life1/14/20201/4/2024
InactiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities1/14/20201/4/2024
InactiveJefferson Pilot Financial Insurance Company300756Agent - Health10/2/20067/2/2007
InactiveJefferson Pilot Financial Insurance Company300756Agent - Life10/2/20067/2/2007
InactiveJefferson Pilot Financial Insurance Company300756Agent - Variable Life and Variable Annuities10/2/20067/2/2007
InactiveJefferson-Pilot Life Insurance Company300379Agent - Health10/2/20064/2/2007
InactiveJefferson-Pilot Life Insurance Company300379Agent - Life10/2/20064/2/2007
InactiveJefferson-Pilot Life Insurance Company300379Agent - Variable Life and Variable Annuities10/2/20064/2/2007
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life2/19/200411/1/2012
InactiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Variable Life and Variable Annuities2/19/200411/1/2012
InactiveLincoln National Life Insurance Company (The)301382Agent - Health12/4/201210/25/2019
InactiveLincoln National Life Insurance Company (The)301382Agent - Life12/4/201210/25/2019
InactiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities12/4/201210/25/2019
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Health2/23/201111/1/2012
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Life2/23/201111/1/2012
InactiveMassachusetts Mutual Life Insurance Company300445Agent - Variable Life and Variable Annuities2/23/201111/1/2012
InactiveMetLife Investors Insurance Company301872Agent - Health12/19/201211/14/2014
InactiveMetLife Investors Insurance Company301872Agent - Life12/19/201211/14/2014
InactiveMetLife Investors Insurance Company301872Agent - Variable Life and Variable Annuities12/19/201211/14/2014
InactiveMetLife Investors USA Insurance Company300845Agent - Health12/19/201211/14/2014
InactiveMetLife Investors USA Insurance Company300845Agent - Life12/19/201211/14/2014
InactiveMetLife Investors USA Insurance Company300845Agent - Variable Life and Variable Annuities12/19/201211/14/2014
ActiveMetropolitan Life Insurance Company301948Agent - Health10/17/2013 
ActiveMetropolitan Life Insurance Company301948Agent - Life10/17/2013 
ActiveMetropolitan Life Insurance Company301948Agent - Variable Life and Variable Annuities10/17/2013 
InactiveMinnesota Life Insurance Company300488Agent - Health6/25/20194/9/2024
InactiveMinnesota Life Insurance Company300488Agent - Life6/25/20194/9/2024
InactiveMinnesota Life Insurance Company300488Agent - Variable Life and Variable Annuities6/25/20194/9/2024
InactiveNationwide Life Insurance Company300495Agent - Health6/17/201312/15/2014
InactiveNationwide Life Insurance Company300495Agent - Life6/17/201312/15/2014
InactiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities6/17/201312/15/2014
InactiveNationwide Life and Annuity Insurance Company300714Agent - Health6/17/201312/15/2014
InactiveNationwide Life and Annuity Insurance Company300714Agent - Life6/17/201312/15/2014
InactiveNationwide Life and Annuity Insurance Company300714Agent - Variable Life and Variable Annuities6/17/201312/15/2014
ActivePacific Life Insurance Company301848Agent - Life6/19/2013 
ActivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities6/19/2013 
ActivePrincipal National Life Insurance Company301926Agent - Life11/16/2016 
ActivePrincipal National Life Insurance Company301926Agent - Variable Life and Variable Annuities11/16/2016 
InactiveProtective Life Insurance Company300638Agent - Health1/8/202011/23/2021
InactiveProtective Life Insurance Company300638Agent - Life1/8/202011/23/2021
InactiveProtective Life Insurance Company300638Agent - Variable Life and Variable Annuities1/8/202011/23/2021
InactivePruco Life Insurance Company300954Agent - Health8/15/200711/1/2012
ActivePruco Life Insurance Company300954Agent - Life11/19/2020 
ActivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities11/19/2020 
InactivePrudential Insurance Company of America300784Agent - Health8/15/200711/1/2012
InactivePrudential Insurance Company of America300784Agent - Life8/15/200711/1/2012
InactivePrudential Insurance Company of America300784Agent - Variable Life and Variable Annuities8/15/200711/1/2012
InactiveSunAmerica Annuity and Life Assurance Company301930Agent - Life12/2/200412/15/2009
InactiveSunAmerica Annuity and Life Assurance Company301930Agent - Variable Life and Variable Annuities12/2/200411/30/2010
InactiveSymetra Life Insurance Company301691Agent - Health10/20/201612/20/2018
InactiveSymetra Life Insurance Company301691Agent - Life10/20/201612/20/2018
InactiveSymetra Life Insurance Company301691Agent - Variable Life and Variable Annuities10/20/201612/20/2018
InactiveTalcott Resolution Life Insurance Company301759Agent - Health1/15/201412/24/2015
InactiveTalcott Resolution Life Insurance Company301759Agent - Life1/15/201412/24/2015
InactiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities1/15/201412/24/2015
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Health1/15/201412/24/2015
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life1/15/201412/24/2015
InactiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities1/15/201412/24/2015
ActiveTransamerica Life Insurance Company300571Agent - Life8/22/2016 
ActiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities8/22/2016 
InactiveUnited of Omaha Life Insurance Company300156Agent - Health10/2/20138/22/2014
InactiveVenerable Insurance and Annuity Company301006Agent - Life9/3/20038/28/2008
InactiveVenerable Insurance and Annuity Company301006Agent - Variable Life and Variable Annuities9/3/20038/28/2008
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveBaird Insurance Services Inc399048Agent - Health11/1/2019 
ActiveBaird Insurance Services Inc399048Agent - Life11/1/2019 
ActiveBaird Insurance Services Inc399048Agent - Variable Life and Variable Annuities11/1/2019 
InactiveJ.J.B. Hilliard, W.L. Lyons, LLC679616Agent - Health1/26/20153/31/2020
InactiveJ.J.B. Hilliard, W.L. Lyons, LLC679616Agent - Life1/26/20153/31/2020
InactiveJ.J.B. Hilliard, W.L. Lyons, LLC679616Agent - Variable Life and Variable Annuities1/26/20153/31/2020
InactiveJJB Hilliard, WL Lyons LLC526305Agent - Health12/18/20037/6/2011
InactiveJJB Hilliard, WL Lyons LLC526305Agent - Life12/18/20037/6/2011
InactiveJJB Hilliard, WL Lyons LLC526305Agent - Variable Life and Variable Annuities12/18/20037/6/2011

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