DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Jacobson, Norman J	DOIID	653835	NAIC NPN	9059626

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	4/19/2007		11/30/2026
Active	Non Resident	Agent	Life	4/19/2007		11/30/2026
* 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
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	4/14/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Health	7/17/2014	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/17/2014	4/15/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Designated Agent Company Inc.	681257	Agent - Health	7/17/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Life	7/17/2014	4/15/2025