DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Wieners, Jeffrey William	DOIID	869758	NAIC NPN	7903425

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	10/18/2016	5/31/2020
Inactive	Non Resident	Agent	Health	10/18/2016	5/31/2020
* 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	CompBenefits Dental, Inc.	591692	Agent - Health	6/16/2015	5/31/2016
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	11/2/2016	1/24/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	11/5/2016	1/24/2017
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	11/5/2016	1/24/2017
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	11/2/2016	1/24/2017
Inactive	Humana Insurance Company	301104	Agent - Health	11/2/2016	1/24/2017
Inactive	Humana Insurance Company	301104	Agent - Life	11/2/2016	1/24/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/2/2016	1/24/2017
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/2/2016	1/24/2017
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	11/5/2016	1/24/2017
Inactive	Kanawha Insurance Company	300127	Agent - Health	2/24/2015	5/31/2016
Inactive	Kanawha Insurance Company	300127	Agent - Life	2/24/2015	5/31/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	2/15/2017	7/31/2018
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	2/15/2017	7/31/2018
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	2/15/2017	7/31/2018
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	2/15/2017	4/30/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	2/24/2017	7/31/2018
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	2/24/2017	7/31/2018
Denied	Usi Insurance Services LLC	669260	Agent - Life
Denied	Usi Insurance Services LLC	669260	Agent - Health