DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Nielson, Jeffrey Wayne	DOIID	783645	NAIC NPN	8971036

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	6/9/2012		8/31/2026
Active	Non Resident	Agent	Health	6/9/2012		8/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	06/15/2024	08/31/2024	07/12/2024	07/12/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aetna Health Inc. (PA)	660717	Agent - Health	6/15/2012	5/18/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Health	6/15/2012	5/18/2024
Inactive	Aetna Life Insurance Company	301140	Agent - Life	6/15/2012	5/18/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Gallagher Benefit Services Inc	525782	Agent - Life	3/5/2024	5/18/2024
Inactive	Gallagher Benefit Services Inc	525782	Agent - Health	3/5/2024	5/18/2024