DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Hatfield, Jack E	DOIID	696748	NAIC NPN	10915521

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	1/7/2009	10/5/2011
Inactive	Non Resident	Agent	Life	1/7/2009	10/5/2011
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	3/5/2009	10/6/2011
Inactive	Aetna Life Insurance Company	301140	Agent - Health	3/5/2009	10/6/2011
Inactive	Aetna Life Insurance Company	301140	Agent - Life	3/5/2009	10/6/2011
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Health	8/6/2010	12/22/2011
Inactive	Berkshire Life Insurance Company of America	300983	Agent - Life	8/6/2010	12/22/2011
Inactive	Guardian Life Insurance Company of America	301316	Agent - Health	8/6/2010	10/5/2011
Inactive	Guardian Life Insurance Company of America	301316	Agent - Life	8/6/2010	10/5/2011
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	2/13/2009	11/18/2011
Inactive	Humana Insurance Company	301104	Agent - Health	2/13/2009	11/18/2011
Inactive	Humana Insurance Company	301104	Agent - Life	2/13/2009	11/18/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	2/13/2009	11/18/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	2/13/2009	11/18/2011
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/13/2009	11/18/2011
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/13/2009	11/18/2011
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	2/12/2009	12/15/2009
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	2/12/2009	12/15/2009
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	2/12/2009	12/15/2009
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	2/12/2009	12/15/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Paychex Insurance Agency Inc	509469	Agent - Health	2/12/2009	2/18/2011
Inactive	Paychex Insurance Agency Inc	509469	Agent - Life	2/12/2009	2/18/2011