DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Bergen, Jeffrey N	DOIID	750096	NAIC NPN	16171754

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/16/2011	11/30/2024
Inactive	Non Resident	Agent	Life	3/16/2011	11/30/2024
* 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	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	6/14/2024	7/3/2024
Inactive	Medico Insurance Company	301559	Agent - Health	1/29/2020	4/4/2022
Inactive	Medico Insurance Company	301559	Agent - Life	1/29/2020	4/4/2022
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	3/29/2011	10/31/2011
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	6/14/2024	7/3/2024
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/8/2016	12/20/2018
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/5/2019	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/15/2018	12/23/2021
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	3/29/2011	3/27/2015
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	6/14/2024	7/3/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Catalyst360 LLC	652333	Agent - Health	4/6/2011	6/7/2024