DEPARTMENT OF INSURANCE

Affiliations

Name	Jackson, Shirley Ann	DOIID	795586	NAIC NPN	16801011

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	10/1/2018	3/31/2020
Inactive	Non Resident	Agent	Life	10/1/2018	3/31/2020
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	3/8/2016	3/31/2018
Inactive	Aetna Life Insurance Company	301140	Agent - Health	3/8/2016	3/31/2018
Inactive	Aetna Life Insurance Company	301140	Agent - Life	11/8/2012	3/31/2014
Inactive	American Continental Insurance Company	643130	Agent - Health	11/2/2012	3/31/2014
Inactive	American General Life Insurance Company	301585	Agent - Health	2/8/2017	3/31/2018
Inactive	Anthem Life Insurance Company	301209	Agent - Health	10/30/2012	3/31/2014
Inactive	Anthem Life Insurance Company	301209	Agent - Life	10/30/2012	3/31/2014
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	10/10/2018	1/15/2019
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	10/25/2012	1/8/2013
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018	3/31/2018
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	1/27/2017	3/31/2018
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	10/25/2012	1/8/2013
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	11/9/2012	2/8/2013
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/10/2018	1/15/2019
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2018	1/15/2019
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	10/10/2018	1/15/2019
Inactive	Humana Insurance Company	301104	Agent - Health	10/10/2018	1/15/2019
Inactive	Humana Insurance Company	301104	Agent - Life	10/10/2018	1/15/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	10/10/2018	1/15/2019
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	10/10/2018	1/15/2019
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/10/2018	1/15/2019
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/10/2018	1/15/2019
Inactive	Independent Order of Foresters	300743	Agent - Life	2/21/2013	3/31/2014
Inactive	Medco Containment Life Insurance Company	301557	Agent - Health	11/11/2012	12/18/2013
Inactive	SilverScript Insurance Company	663526	Agent - Health	11/7/2012	3/31/2014
Inactive	Unified Life Insurance Company	543169	Agent - Health	3/6/2017	12/12/2017
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	11/1/2012	1/9/2013
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	11/1/2012	1/9/2013
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	1/17/2013	2/12/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	10/30/2012	3/31/2014
Inactive	Designated Agent Company Inc.	681257	Agent - Health	10/30/2012	3/31/2014