DEPARTMENT OF INSURANCE

Affiliations

Name	Mirts, Hazen Jason	DOIID	615788	NAIC NPN	5961468

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	9/26/2005	12/31/2026
Active	Non Resident	Agent	Life	9/26/2005	12/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	10/15/2026	12/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	2/23/2010	1/9/2022
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	2/23/2010	1/9/2022
Inactive	American Fidelity Assurance Company	301004	Agent - Health	11/6/2007	12/24/2008
Inactive	American Fidelity Assurance Company	301004	Agent - Life	11/6/2007	12/24/2008
Inactive	American General Assurance Company	300586	Agent - Health	3/29/2006	12/31/2012
Inactive	American General Assurance Company	300586	Agent - Life	3/29/2006	12/31/2012
Inactive	American General Life Insurance Company	301585	Agent - Health	12/7/2011	1/8/2018
Inactive	American General Life Insurance Company	301585	Agent - Life	12/7/2011	1/8/2018
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	3/9/2012	12/31/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	3/9/2012	12/31/2012
Active	American Heritage Life Insurance Company	300272	Agent - Health	3/10/2020
Active	American Heritage Life Insurance Company	300272	Agent - Life	3/10/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/26/2013	12/16/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/26/2013	12/16/2024
Inactive	Assurity Life Insurance Company	301099	Agent - Health	8/15/2024	12/9/2024
Inactive	Assurity Life Insurance Company	301099	Agent - Life	8/15/2024	12/9/2024
Active	Boston Mutual Life Insurance Company	300143	Agent - Health	5/15/2020
Active	Boston Mutual Life Insurance Company	300143	Agent - Life	5/15/2020
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	4/9/2013	12/10/2018
Inactive	Connecticut General Life Insurance Company	301333	Agent - Health	3/2/2012	6/11/2014
Inactive	Connecticut General Life Insurance Company	301333	Agent - Life	3/2/2012	6/11/2014
Inactive	Continental American Insurance Company	301700	Agent - Health	10/23/2006	1/3/2022
Inactive	Continental American Insurance Company	301700	Agent - Life	10/23/2006	1/3/2022
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	4/9/2013	12/10/2018
Inactive	Golden Rule Insurance Company	301943	Agent - Health	12/24/2013	1/4/2022
Inactive	Golden Rule Insurance Company	301943	Agent - Life	12/24/2013	1/4/2022
Inactive	HCC Life Insurance Company	301827	Agent - Health	3/7/2016	10/3/2016
Inactive	HM Life Insurance Company	301408	Agent - Health	3/22/2007	12/29/2016
Inactive	HM Life Insurance Company	301408	Agent - Life	3/22/2007	12/29/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	8/5/2014	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/6/2013	12/10/2018
Inactive	Humana Insurance Company	301104	Agent - Health	4/9/2013	12/10/2018
Inactive	Humana Insurance Company	301104	Agent - Life	8/4/2014	12/10/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/4/2014	12/10/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/4/2014	12/10/2018
Inactive	HumanaDental Insurance Company	301457	Agent - Health	3/23/2012	12/14/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	3/23/2012	12/14/2012
Inactive	John Alden Life Insurance Company	300573	Agent - Health	1/21/2006	1/24/2013
Inactive	John Alden Life Insurance Company	300573	Agent - Life	1/21/2006	1/24/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/6/2013	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/6/2013	10/22/2015
Active	NGL Insurance Company	300596	Agent - Health	7/8/2019
Active	National Health Insurance Company	300554	Agent - Health	10/4/2022
Active	National Health Insurance Company	300554	Agent - Life	10/4/2022
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	10/27/2009
Inactive	Time Insurance Company	300683	Agent - Health	10/30/2012	11/22/2019
Inactive	Time Insurance Company	300683	Agent - Life	10/30/2012	11/22/2019
Active	Transamerica Life Insurance Company	300571	Agent - Health	3/26/2025
Active	Transamerica Life Insurance Company	300571	Agent - Life	3/26/2025
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Health	6/5/2007	10/1/2008
Inactive	Transamerica Occidental Life Insurance Company	300966	Agent - Life	6/5/2007	10/1/2008
Inactive	Unified Life Insurance Company	543169	Agent - Health	3/9/2016	12/12/2017
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/12/2015	11/4/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/12/2015	11/4/2016
Active	Wellfleet Insurance Company	300542	Agent - Health	6/24/2020

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	11/26/2013	2/10/2025
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/26/2013	2/10/2025
Active	Enrollment First, Inc	644197	Agent - Life	11/15/2006
Active	Enrollment First, Inc	644197	Agent - Health	11/15/2006
Inactive	Insurance First Inc	676575	Agent - Life	3/20/2008	3/31/2010
Inactive	Insurance First Inc	676575	Agent - Health	3/20/2008	3/31/2010