DEPARTMENT OF INSURANCE

Affiliations

Name	Jackson, David Lee	DOIID	771742	NAIC NPN	16453872

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	1/1/2012	6/17/2016
Inactive	Non Resident	Agent	Health	1/1/2012	6/17/2016
* 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 General Life Insurance Company	301585	Agent - Health	5/14/2015	6/17/2016
Inactive	American General Life Insurance Company	301585	Agent - Life	5/14/2015	6/17/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/5/2014	6/17/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/5/2014	6/17/2016
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	1/7/2015	6/17/2016
Inactive	Colorado Bankers Life Insurance Company	301845	Agent - Health	4/21/2016	6/17/2016
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/5/2012	6/17/2016
Inactive	Companion Life Insurance Company	300191	Agent - Health	6/27/2013	6/17/2016
Inactive	Companion Life Insurance Company	300191	Agent - Life	6/27/2013	6/17/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/5/2012	6/17/2016
Inactive	Golden Rule Insurance Company	301943	Agent - Health	4/19/2013	6/17/2016
Inactive	Golden Rule Insurance Company	301943	Agent - Life	4/19/2013	6/17/2016
Inactive	HCC Life Insurance Company	301827	Agent - Health	3/16/2015	6/17/2016
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	6/17/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/12/2012	6/17/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/5/2012	6/17/2016
Inactive	Humana Insurance Company	301104	Agent - Health	3/5/2012	6/17/2016
Inactive	Humana Insurance Company	301104	Agent - Life	3/5/2012	6/17/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	3/5/2012	6/17/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	3/5/2012	6/17/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	6/17/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/5/2012	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/5/2012	10/22/2015
Inactive	Security Life Insurance Company of America	300936	Agent - Health	7/8/2015	6/17/2016
Inactive	Security Life Insurance Company of America	300936	Agent - Life	7/8/2015	6/17/2016
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	9/18/2014	6/17/2016
Inactive	Time Insurance Company	300683	Agent - Health	3/8/2013	6/17/2016
Inactive	Time Insurance Company	300683	Agent - Life	3/8/2013	6/17/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	11/12/2015	6/17/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	11/12/2015	6/17/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Agent Franchise LLC	860806	Agent - Life	11/13/2014	3/31/2016
Inactive	Agent Franchise LLC	860806	Agent - Health	11/13/2014	3/31/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Life	3/5/2014	6/17/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	3/5/2014	6/17/2016