DEPARTMENT OF INSURANCE

Affiliations

Name	Jackson, Otis D	DOIID	887147	NAIC NPN	1973231

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	8/15/2015	6/30/2018
Inactive	Non Resident	Agent	Health	8/15/2015	6/30/2018
* 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	8/18/2015	6/30/2018
Inactive	Aetna Health and Life Insurance Company	300523	Agent - Health	5/18/2018	6/30/2018
Inactive	Aetna Life Insurance Company	301140	Agent - Health	8/18/2015	6/30/2018
Inactive	Aetna Life Insurance Company	301140	Agent - Life	8/18/2015	6/30/2018
Inactive	American Continental Insurance Company	643130	Agent - Life	5/18/2018	6/30/2018
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	8/29/2015	5/1/2016
Inactive	CIGNA Health & Life Insurance Company	301783	Agent - Health	8/19/2015	3/16/2017
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/9/2015	11/2/2016
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	5/18/2018	6/30/2018
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/9/2015	11/2/2016
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	8/18/2015	6/30/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/9/2015	11/2/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/9/2015	11/2/2016
Inactive	Humana Insurance Company	301104	Agent - Health	9/9/2015	11/2/2016
Inactive	Humana Insurance Company	301104	Agent - Life	9/10/2015	11/2/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/9/2015	11/2/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/10/2015	11/2/2016
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	11/2/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/9/2015	11/3/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/9/2015	11/3/2015
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	9/29/2015	11/14/2016
Inactive	Loyal American Life Insurance Company	301172	Agent - Life	9/29/2015	11/14/2016
Inactive	Medco Containment Life Insurance Company	301557	Agent - Health	9/25/2015	6/30/2018
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/22/2015	6/30/2018
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	9/23/2015	12/31/2015
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	9/23/2015	12/31/2015
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/23/2015	12/31/2015
Inactive	WellCare Prescription Insurance Inc.	654329	Agent - Health	10/26/2015	3/8/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Extend Insurance Services, LLC	625753	Agent - Health	8/30/2017	1/31/2018
Inactive	Extend Insurance Services, LLC	625753	Agent - Life	8/30/2017	1/31/2018