DEPARTMENT OF INSURANCE

Affiliations

Name	Lewis, Jack D	DOIID	771559	NAIC NPN	2772499

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	12/29/2011	11/30/2022
Inactive	Non Resident	Agent	Health	12/29/2011	11/30/2022
Inactive	Non Resident	Agent	Casualty	12/29/2011	11/30/2022
Inactive	Non Resident	Agent	Property	12/29/2011	11/30/2022
* 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	5 Star Life Insurance Company	300673	Agent - Health	12/13/2013	12/30/2014
Inactive	5 Star Life Insurance Company	300673	Agent - Life	12/13/2013	12/30/2014
Inactive	Accendo Insurance Company	300312	Agent - Life	6/10/2020	11/30/2022
Inactive	Allstate Indemnity Company	300778	Agent - Casualty	2/7/2014	3/6/2014
Inactive	Allstate Indemnity Company	300778	Agent - Property	2/7/2014	3/6/2014
Inactive	Allstate Insurance Company	300773	Agent - Casualty	2/7/2014	3/6/2014
Inactive	Allstate Insurance Company	300773	Agent - Property	2/7/2014	3/6/2014
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	2/7/2014	3/6/2014
Inactive	Allstate Property and Casualty Insurance Company	300593	Agent - Property	2/7/2014	3/6/2014
Inactive	American Continental Insurance Company	643130	Agent - Life	9/27/2013	12/6/2021
Inactive	American Family Home Insurance Company	301817	Agent - Casualty	6/20/2018	7/6/2018
Inactive	American Family Home Insurance Company	301817	Agent - Property	6/20/2018	7/6/2018
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	7/20/2017	1/4/2018
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	7/20/2017	1/4/2018
Inactive	American General Life Insurance Company	301585	Agent - Health	9/21/2017	6/10/2022
Inactive	American General Life Insurance Company	301585	Agent - Life	9/21/2017	6/10/2022
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	6/20/2018	7/6/2018
Inactive	American Modern Home Insurance Company	300791	Agent - Property	6/20/2018	7/6/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	6/20/2018	7/6/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Property	6/20/2018	7/6/2018
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	6/20/2018	7/6/2018
Inactive	American Southern Home Insurance Company	626276	Agent - Property	6/20/2018	7/6/2018
Inactive	Anthem Life Insurance Company	301209	Agent - Health	11/2/2012	6/23/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	11/2/2012	6/23/2015
Inactive	Athene Annuity and Life Company	301893	Agent - Life	9/4/2013	12/16/2014
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	5/18/2015	1/2/2018
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	5/18/2015	1/2/2018
Inactive	Bankers Life and Casualty Company	300701	Agent - Health	5/29/2014	1/21/2015
Inactive	Bankers Life and Casualty Company	300701	Agent - Life	5/29/2014	1/21/2015
Inactive	CSAA Fire & Casualty Insurance Company	606666	Agent - Casualty	9/23/2015	11/30/2022
Inactive	CSAA Fire & Casualty Insurance Company	606666	Agent - Property	9/23/2015	11/30/2022
Inactive	CSAA General Insurance Company	606675	Agent - Casualty	9/23/2015	11/30/2022
Inactive	CSAA General Insurance Company	606675	Agent - Property	9/23/2015	11/30/2022
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Health	3/9/2020	2/23/2022
Inactive	Colonial Life and Accident Insurance Company	300846	Agent - Life	3/9/2020	2/23/2022
Inactive	Colonial Penn Life Insurance Company	300491	Agent - Health	5/29/2014	1/21/2015
Inactive	Colonial Penn Life Insurance Company	300491	Agent - Life	5/29/2014	1/21/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/12/2013	12/5/2014
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/11/2020	11/30/2022
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/12/2013	12/5/2014
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	5/8/2015	12/31/2015
Inactive	Encompass Indemnity Company	546376	Agent - Property	5/8/2015	12/31/2015
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	5/8/2015	12/31/2015
Inactive	Encompass Insurance Company of America	556578	Agent - Property	5/8/2015	12/31/2015
Inactive	GEICO General Insurance Company	301684	Agent - Casualty	12/16/2018	1/30/2019
Inactive	GEICO General Insurance Company	301684	Agent - Property	12/16/2018	1/30/2019
Inactive	GEICO Indemnity Company	301720	Agent - Casualty	12/16/2018	1/30/2019
Inactive	GEICO Indemnity Company	301720	Agent - Property	12/16/2018	1/30/2019
Inactive	Government Employees Insurance Company	300376	Agent - Casualty	12/16/2018	1/30/2019
Inactive	Government Employees Insurance Company	300376	Agent - Property	12/16/2018	1/30/2019
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	6/25/2014	4/6/2016
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	6/25/2014	4/6/2016
Inactive	Grange Insurance Company	300234	Agent - Casualty	6/25/2014	4/6/2016
Inactive	Grange Insurance Company	300234	Agent - Property	6/25/2014	4/6/2016
Inactive	Grange Life Insurance Company	300128	Agent - Health	6/25/2014	4/6/2016
Inactive	Grange Life Insurance Company	300128	Agent - Life	6/25/2014	4/6/2016
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	6/25/2014	4/6/2016
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	6/25/2014	4/6/2016
Inactive	Horace Mann Life Insurance Company	300852	Agent - Health	12/7/2020	12/14/2020
Inactive	Horace Mann Life Insurance Company	300852	Agent - Life	12/7/2020	12/14/2020
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	5/4/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/12/2013	12/5/2014
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/12/2013	12/5/2014
Inactive	Humana Insurance Company	301104	Agent - Health	9/12/2013	5/4/2015
Inactive	Humana Insurance Company	301104	Agent - Life	9/12/2013	5/4/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/12/2013	12/5/2014
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/12/2013	12/5/2014
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	5/4/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/12/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/12/2013	12/5/2014
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	10/31/2016	1/10/2017
Inactive	National Teachers Associates Life Insurance Company	300107	Agent - Health	9/28/2017	11/30/2017
Inactive	National Teachers Associates Life Insurance Company	300107	Agent - Life	9/28/2017	11/30/2017
Inactive	Omaha Insurance Company	751908	Agent - Health	10/31/2016	1/10/2017
Inactive	Physicians Life Insurance Company	300924	Agent - Life	10/23/2014	12/10/2014
Inactive	Physicians Mutual Insurance Company	301084	Agent - Health	10/23/2014	12/10/2014
Inactive	Reserve National Insurance Company	301073	Agent - Health	3/7/2022	1/25/2023
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	5/18/2015	1/2/2018
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	5/18/2015	1/2/2018
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	5/18/2015	1/2/2018
Inactive	The Phoenix Insurance Company	301502	Agent - Property	5/18/2015	1/2/2018
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	5/18/2015	1/2/2018
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	5/18/2015	1/2/2018
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	6/25/2014	4/6/2016
Inactive	Trustgard Insurance Company	300104	Agent - Property	6/25/2014	4/6/2016
Inactive	United Casualty Insurance Company of America	301322	Agent - Casualty	3/29/2021	7/12/2021
Inactive	United Casualty Insurance Company of America	301322	Agent - Property	3/29/2021	7/12/2021
Inactive	United Insurance Company of America	300775	Agent - Health	3/7/2022	1/25/2023
Inactive	United Insurance Company of America	300775	Agent - Life	3/29/2021	7/12/2021
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	10/31/2016	1/10/2017
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	10/31/2016	1/10/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aaa Allied Insurance Services Inc	546922	Agent - Life	9/11/2015	9/25/2015
Inactive	Aaa Allied Insurance Services Inc	546922	Agent - Health	9/11/2015	9/25/2015
Inactive	Aaa Allied Insurance Services Inc	546922	Agent - Property	9/11/2015	9/25/2015
Inactive	Aaa Allied Insurance Services Inc	546922	Agent - Casualty	9/11/2015	9/25/2015
Inactive	Atlas Ins Agcy Inc	523813	Agent - Property	6/27/2018	7/6/2018
Inactive	Atlas Ins Agcy Inc	523813	Agent - Casualty	6/27/2018	7/6/2018
Inactive	BTFB Agency LLC	1018695	Agent - Property	12/12/2018	1/28/2019
Inactive	BTFB Agency LLC	1018695	Agent - Casualty	12/12/2018	1/28/2019
Inactive	Designated Agent Company Inc.	681257	Agent - Life	11/2/2012	6/23/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	11/2/2012	6/23/2015
Inactive	Horace Mann General Agency Corporation	898360	Agent - Life	9/29/2017	4/10/2018
Inactive	Horace Mann General Agency Corporation	898360	Agent - Health	9/29/2017	4/10/2018
Inactive	Horace Mann Service Corporation	400869	Agent - Life	12/9/2020	12/15/2020
Inactive	Horace Mann Service Corporation	400869	Agent - Health	12/9/2020	12/15/2020
Inactive	Horace Mann Service Corporation	400869	Agent - Property	12/9/2020	12/15/2020
Inactive	Horace Mann Service Corporation	400869	Agent - Casualty	12/9/2020	12/15/2020