DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ford, Jeremy Kenneth	DOIID	713510	NAIC NPN	3230777

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	3/4/2010	6/30/2011
Inactive	Non Resident	Agent	Health	9/15/2009	6/30/2011
Inactive	Non Resident	Agent	Life	9/15/2009	6/30/2011
Inactive	Non Resident	Agent	Casualty	3/4/2010	6/30/2011
Inactive	Non Resident	Staff Adjuster	Property & Casualty	5/10/2018	6/30/2019
* 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	American Bankers Insurance Company of Florida	300360	Agent - Casualty	4/6/2010	12/17/2010
Inactive	American Bankers Insurance Company of Florida	300360	Agent - Property	4/6/2010	12/17/2010
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	1/7/2010	2/26/2010
Inactive	CompBenefits Insurance Company	301864	Agent - Health	1/7/2010	2/26/2010
Inactive	CompBenefits Insurance Company	301864	Agent - Life	1/7/2010	2/26/2010
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/18/2009	2/26/2010
Inactive	Esurance Insurance Company	301072	Agent - Casualty	3/9/2010	4/19/2011
Inactive	Esurance Insurance Company	301072	Agent - Property	3/9/2010	4/19/2011
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/18/2009	2/26/2010
Inactive	Humana Insurance Company	301104	Agent - Health	9/18/2009	2/26/2010
Inactive	Humana Insurance Company	301104	Agent - Life	9/18/2009	2/26/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/18/2009	2/26/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/18/2009	2/26/2010
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/18/2009	2/26/2010
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/18/2009	2/26/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Esurance Ins Services Inc	709770	Agent - Casualty	6/3/2010	4/19/2011
Inactive	Esurance Ins Services Inc	709770	Agent - Property	6/3/2010	4/19/2011
Denied	Humana MarketPOINT Inc.	398092	Agent - Life
Denied	Humana MarketPOINT Inc.	398092	Agent - Health