DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Jackson, David Lee	DOIID	710294	NAIC NPN	14515916

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	2/6/2015	11/30/2021
Inactive	Non Resident	Agent	Health	2/6/2015	11/30/2021
* 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	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/21/2018	8/16/2021
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/12/2021	11/30/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/21/2018	8/16/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/21/2018	8/16/2021
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	10/30/2009	10/13/2011
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/5/2016	8/14/2018
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/11/2016	8/14/2018
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	8/14/2018
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	6/5/2016	12/19/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	6/5/2016	8/14/2018

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 - Health	8/21/2018	8/17/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Life	8/21/2018	8/16/2021