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DEPARTMENT OF INSURANCE
Affiliations
Name
Shaffer, Derek Ryan
DOIID
686322
NAIC NPN
11386258
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Resident
Agent
Health
8/27/2008
5/1/2013
Inactive
Resident
Agent
Life
8/15/2008
5/1/2013
Inactive
Resident
Agent
Variable Life and Variable Annuities
8/15/2008
5/1/2013
* 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.
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Empower Annuity Insurance Company of America
300259
Agent - Life
1/13/2012
12/10/2012
Inactive
Fortitude Life Insurance & Annuity Company
301503
Agent - Life
8/29/2008
1/28/2009
Inactive
Fortitude Life Insurance & Annuity Company
301503
Agent - Variable Life and Variable Annuities
8/29/2008
1/28/2009
Inactive
General American Life Insurance Company
300280
Agent - Health
9/1/2008
1/6/2009
Inactive
General American Life Insurance Company
300280
Agent - Life
9/1/2008
1/6/2009
Inactive
General American Life Insurance Company
300280
Agent - Variable Life and Variable Annuities
9/1/2008
1/6/2009
Inactive
Genworth Life Insurance Company
300623
Agent - Health
9/3/2008
9/19/2009
Inactive
Genworth Life Insurance Company
300623
Agent - Life
9/3/2008
9/19/2009
Inactive
Lincoln Life Assurance Company of Boston
301915
Agent - Life
3/10/2011
5/1/2013
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Health
8/27/2008
1/5/2009
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Life
8/27/2008
1/5/2009
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Variable Life and Variable Annuities
8/27/2008
1/5/2009
Inactive
MetLife Investors Insurance Company
301872
Agent - Health
9/1/2008
1/6/2009
Inactive
MetLife Investors Insurance Company
301872
Agent - Life
9/1/2008
1/6/2009
Inactive
MetLife Investors Insurance Company
301872
Agent - Variable Life and Variable Annuities
9/1/2008
1/6/2009
Inactive
MetLife Investors USA Insurance Company
300845
Agent - Health
3/9/2011
12/13/2012
Inactive
MetLife Investors USA Insurance Company
300845
Agent - Life
3/9/2011
12/13/2012
Inactive
MetLife Investors USA Insurance Company
300845
Agent - Variable Life and Variable Annuities
3/9/2011
12/13/2012
Inactive
Metropolitan Life Insurance Company
301948
Agent - Health
9/1/2008
1/6/2009
Inactive
Metropolitan Life Insurance Company
301948
Agent - Life
9/1/2008
1/6/2009
Inactive
Metropolitan Life Insurance Company
301948
Agent - Variable Life and Variable Annuities
9/1/2008
1/6/2009
Inactive
New England Life Insurance Company
300343
Agent - Health
9/1/2008
1/6/2009
Inactive
New England Life Insurance Company
300343
Agent - Life
9/1/2008
1/6/2009
Inactive
New England Life Insurance Company
300343
Agent - Variable Life and Variable Annuities
9/1/2008
1/6/2009
Inactive
New York Life Insurance and Annuity Corporation
300726
Agent - Life
3/15/2011
12/18/2012
Inactive
New York Life Insurance and Annuity Corporation
300726
Agent - Variable Life and Variable Annuities
3/15/2011
12/18/2012
Inactive
Pacific Life Insurance Company
301848
Agent - Life
8/29/2008
11/10/2009
Inactive
Pacific Life Insurance Company
301848
Agent - Variable Life and Variable Annuities
8/29/2008
11/10/2009
Inactive
Protective Life Insurance Company
300638
Agent - Health
8/29/2008
1/5/2009
Inactive
Protective Life Insurance Company
300638
Agent - Life
8/29/2008
1/5/2009
Inactive
Protective Life Insurance Company
300638
Agent - Variable Life and Variable Annuities
8/29/2008
1/5/2009
Inactive
Pruco Life Insurance Company
300954
Agent - Life
8/29/2008
1/28/2009
Inactive
Pruco Life Insurance Company
300954
Agent - Variable Life and Variable Annuities
8/29/2008
1/28/2009
Inactive
SunAmerica Annuity and Life Assurance Company
301930
Agent - Life
9/24/2008
12/1/2010
Inactive
SunAmerica Annuity and Life Assurance Company
301930
Agent - Variable Life and Variable Annuities
9/24/2008
12/1/2010
Inactive
Symetra Life Insurance Company
301691
Agent - Health
6/21/2011
12/19/2012
Inactive
Symetra Life Insurance Company
301691
Agent - Life
6/21/2011
12/19/2012
Inactive
Symetra Life Insurance Company
301691
Agent - Variable Life and Variable Annuities
6/21/2011
12/19/2012
Inactive
Talcott Resolution Life Insurance Company
301759
Agent - Life
9/4/2008
2/20/2009
Inactive
Talcott Resolution Life Insurance Company
301759
Agent - Variable Life and Variable Annuities
9/4/2008
2/20/2009
Inactive
Talcott Resolution Life and Annuity Insurance Company
300932
Agent - Life
9/4/2008
2/20/2009
Inactive
Talcott Resolution Life and Annuity Insurance Company
300932
Agent - Variable Life and Variable Annuities
9/4/2008
2/20/2009
Inactive
Transamerica Life Insurance Company
300571
Agent - Life
3/9/2011
5/1/2013
Inactive
Transamerica Life Insurance Company
300571
Agent - Variable Life and Variable Annuities
3/9/2011
5/1/2013
Inactive
Western National Life Insurance Company
300461
Agent - Life
6/20/2011
12/11/2012
Inactive
Western-Southern Life Assurance Company
301590
Agent - Health
3/10/2011
5/1/2013
Inactive
Western-Southern Life Assurance Company
301590
Agent - Life
3/10/2011
5/1/2013
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Edward D Jones & Co. Limited Partnership
398146
Agent - Variable Life and Variable Annuities
9/2/2008
1/12/2009
Inactive
Edward D Jones & Co. Limited Partnership
398146
Agent - Life
9/2/2008
1/12/2009
Inactive
Edward D Jones & Co. Limited Partnership
398146
Agent - Health
9/2/2008
1/12/2009
Inactive
U S Bancorp Ins Services L L C
400253
Agent - Variable Life and Variable Annuities
5/4/2011
12/6/2012
Inactive
U S Bancorp Ins Services L L C
400253
Agent - Life
3/9/2011
12/6/2012
Inactive
U S Bancorp Ins Services L L C
400253
Agent - Health
3/9/2011
12/6/2012
Inactive
US Bancorp Investments, Inc.
572662
Agent - Variable Life and Variable Annuities
5/4/2011
12/6/2012
Inactive
US Bancorp Investments, Inc.
572662
Agent - Life
3/9/2011
12/6/2012
Inactive
US Bancorp Investments, Inc.
572662
Agent - Health
5/4/2011
12/6/2012
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