DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Baltas, Jeffrey Thomas Rex	DOIID	589880	NAIC NPN	7522112

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Administrator	Not Applicable	2/23/2010	2/28/2017
Inactive	Resident	Agent	Health	8/26/2009	3/1/2017
Inactive	Resident	Agent	Life	8/26/2009	3/1/2017
* 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	American Heritage Life Insurance Company	300272	Agent - Health	1/14/2008	3/1/2009
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	1/14/2008	3/1/2009
Inactive	Augustar Life Assurance Corporation	301113	Agent - Health	12/1/2004	8/8/2006
Inactive	Augustar Life Assurance Corporation	301113	Agent - Life	9/28/2004	8/8/2006
Inactive	Augustar Life Insurance Company	301816	Agent - Health	12/1/2004	8/8/2006
Inactive	Augustar Life Insurance Company	301816	Agent - Life	9/28/2004	8/8/2006
Inactive	BaltasVision, LLC	598376	Agent - Health	6/11/2010	3/1/2017
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Health	6/2/2010	7/17/2013
Inactive	Boston Mutual Life Insurance Company	300143	Agent - Life	6/2/2010	7/17/2013
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	6/9/2004	3/26/2007
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	6/9/2004	3/26/2007
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	8/2/2012	3/1/2017
Inactive	Transamerica Life Insurance Company	300571	Agent - Health	10/1/2008	3/1/2009
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	10/1/2008	3/1/2009
Inactive	Transamerica Life Insurance and Annuity Company	300148	Agent - Life	9/21/2004	8/16/2005
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	9/21/2004	10/1/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	9/21/2004	10/1/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Employee Benefits Administrators, Inc.	401273	Agent - Health	6/10/2010	3/31/2014
Inactive	Employee Benefits Administrators, Inc.	401273	Agent - Life	6/10/2010	7/17/2013
Inactive	Employee Benefits Administrators, Inc.	401273	Administrator - Not Applicable	6/4/2012	3/31/2014
Inactive	Healthsmart Benefit Solutions Inc	396190	Agent - Health	3/2/2015	3/1/2017
Inactive	Healthsmart Benefit Solutions Inc	396190	Agent - Life	3/6/2013	7/17/2013
Inactive	The Partners Workplace Solutions Group, Inc.	695818	Agent - Health	6/10/2010	3/31/2016
Inactive	The Partners Workplace Solutions Group, Inc.	695818	Agent - Life	6/10/2010	7/17/2013