DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Bender, Jaclyn Nicole	DOIID	641631	NAIC NPN	8938399

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Life	12/27/2006	4/1/2015
Inactive	Resident	Agent	Health	12/27/2006	4/1/2015
* 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	Colonial Life and Accident Insurance Company	300846	Agent - Health	8/14/2013	4/1/2015
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	8/14/2013	4/1/2015
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/21/2009	11/27/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2007	11/27/2010
Inactive	Humana Insurance Company	301104	Agent - Health	3/1/2007	11/27/2010
Inactive	Humana Insurance Company	301104	Agent - Life	3/1/2007	11/27/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/1/2007	11/27/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/1/2007	11/27/2010
Inactive	Kanawha Insurance Company	300127	Agent - Health	11/8/2010	11/27/2010
Inactive	Kanawha Insurance Company	300127	Agent - Life	11/8/2010	11/27/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Medlink Inc	400721	Agent - Health	3/1/2007	11/27/2010
Inactive	Medlink Inc	400721	Agent - Life	3/1/2007	11/27/2010