DEPARTMENT OF INSURANCE

Affiliations

Name	Jackson, Benjamin D	DOIID	814069	NAIC NPN	16398927

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	7/9/2013	3/7/2016
Inactive	Non Resident	Agent	Health	7/9/2013	3/7/2016
* 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	Aetna Health Inc. (PA)	660717	Agent - Health	11/25/2014	3/7/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Health	11/25/2014	3/7/2016
Inactive	Aetna Life Insurance Company	301140	Agent - Life	11/25/2014	3/7/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Health	7/29/2013	9/1/2015
Inactive	Anthem Life Insurance Company	301209	Agent - Life	7/29/2013	9/1/2015
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	5/12/2015	12/8/2015
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	11/25/2014	3/7/2016
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Life	11/25/2014	3/7/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	5/12/2015	12/8/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Health	5/4/2015	3/7/2016
Inactive	Golden Rule Insurance Company	301943	Agent - Life	5/4/2015	3/7/2016
Inactive	HCC Life Insurance Company	301827	Agent - Health	5/19/2015	3/7/2016
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	5/12/2015	12/8/2015
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	5/12/2015	12/8/2015
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	5/12/2015	12/8/2015
Inactive	Humana Insurance Company	301104	Agent - Health	5/12/2015	12/8/2015
Inactive	Humana Insurance Company	301104	Agent - Life	5/12/2015	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	5/12/2015	12/8/2015
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	5/12/2015	12/8/2015
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	5/12/2015	12/8/2015
Inactive	Kanawha Insurance Company	300127	Agent - Health	5/12/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	5/12/2015	10/22/2015
Inactive	Time Insurance Company	300683	Agent - Health	3/29/2015	3/7/2016
Inactive	Time Insurance Company	300683	Agent - Life	3/29/2015	3/7/2016
Inactive	Unified Life Insurance Company	543169	Agent - Health	5/6/2015	3/7/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	5/4/2015	3/7/2016
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	5/4/2015	3/7/2016

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	7/29/2013	9/1/2015
Inactive	Designated Agent Company Inc.	681257	Agent - Health	7/29/2013	9/1/2015