DEPARTMENT OF INSURANCE

Affiliations

Name	Jackson, Tracey	DOIID	888640	NAIC NPN	17403916

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Life	8/26/2015	5/31/2017
Inactive	Non Resident	Agent	Health	8/26/2015	5/31/2017
* 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	9/17/2015	5/31/2017
Inactive	Aetna Life Insurance Company	301140	Agent - Health	9/17/2015	5/31/2017
Inactive	Aetna Life Insurance Company	301140	Agent - Life	9/17/2015	5/31/2017
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Health	11/5/2015	4/11/2016
Inactive	Chesapeake Life Insurance Company (The)	301017	Agent - Life	11/5/2015	4/11/2016
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/1/2015	4/19/2016
Inactive	Coventry Health and Life Insurance Company	301771	Agent - Health	9/17/2015	5/31/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	9/1/2015	4/19/2016
Inactive	First Health Life & Health Insurance Company	301735	Agent - Health	9/17/2015	5/31/2017
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	9/1/2015	4/19/2016
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/1/2015	4/19/2016
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/1/2015	4/19/2016
Inactive	Humana Insurance Company	301104	Agent - Health	9/1/2015	4/19/2016
Inactive	Humana Insurance Company	301104	Agent - Life	9/1/2015	4/19/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/1/2015	4/19/2016
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/1/2015	4/19/2016
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	9/1/2015	4/19/2016
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/1/2015	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/1/2015	10/22/2015
Inactive	SilverScript Insurance Company	663526	Agent - Health	9/3/2015	1/3/2017

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	6/7/2016	5/31/2017
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	6/7/2016	5/31/2017
Inactive	eHealthInsurance Services Inc.	514105	Agent - Life	10/8/2015	8/31/2016
Inactive	eHealthInsurance Services Inc.	514105	Agent - Health	10/8/2015	8/31/2016