DEPARTMENT OF INSURANCE

Affiliations

Name	David, Jeremiah Alan	DOIID	913330	NAIC NPN	17833852

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	4/21/2016	11/30/2024
Active	Non Resident	Agent	Health	4/21/2016	11/30/2024
Active	Non Resident	Agent	Personal Lines	7/31/2019	11/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	9/10/2021	11/17/2023
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	5/13/2020
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	7/18/2016
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/20/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	5/13/2020
Inactive	American Republic Insurance Company	300861	Agent - Health	8/1/2021	8/3/2022
Inactive	American Republic Insurance Company	300861	Agent - Life	8/1/2021	8/3/2022
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/10/2023
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	10/10/2023
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	10/10/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	6/12/2020	12/10/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/12/2020	12/10/2021
Inactive	Arcadian Health Plan, Inc.	728196	Agent - Health	4/15/2021	7/21/2021
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	12/5/2016
Active	CIGNA Health & Life Insurance Company	301783	Agent - Life	12/5/2016
Inactive	California Casualty General Insurance Company of Oregon	301081	Agent - Personal Lines	8/9/2019	6/2/2022
Inactive	California Casualty Indemnity Exchange	301153	Agent - Personal Lines	8/20/2019	6/2/2022
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	8/12/2022
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	10/10/2023
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	7/25/2022
Inactive	GPM Health and Life Insurance Company	927255	Agent - Health	6/7/2018	6/24/2019
Inactive	GPM Health and Life Insurance Company	927255	Agent - Life	6/7/2018	6/24/2019
Inactive	Government Personnel Mutual Life Insurance Company	301862	Agent - Health	6/7/2018	4/22/2019
Inactive	Government Personnel Mutual Life Insurance Company	301862	Agent - Life	6/7/2018	4/22/2019
Inactive	Great Southern Life Insurance Company	301443	Agent - Health	10/29/2019	11/30/2021
Active	Humana Insurance Company	301104	Agent - Health	11/21/2022
Inactive	Humana Insurance Company	301104	Agent - Life	11/22/2017	6/8/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	11/22/2017	6/8/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	11/22/2017	6/8/2018
Inactive	Loyal American Life Insurance Company	301172	Agent - Health	5/17/2017	12/21/2018
Inactive	Loyal American Life Insurance Company	301172	Agent - Life	5/17/2017	12/21/2018
Inactive	Manhattan Life Insurance Company	300880	Agent - Health	8/5/2016	1/24/2019
Inactive	ManhattanLife Insurance and Annuity Company	301795	Agent - Health	8/3/2016	7/26/2019
Inactive	Medico Corp Life Insurance Company	301777	Agent - Health	10/5/2016	4/5/2018
Inactive	Medico Corp Life Insurance Company	301777	Agent - Life	10/5/2016	4/5/2018
Inactive	Puritan Life Insurance Company of America	301892	Agent - Health	2/15/2018	8/8/2022
Inactive	SILAC Insurance Company	300535	Agent - Health	5/12/2016	4/9/2018
Inactive	SILAC Insurance Company	300535	Agent - Life	5/12/2016	4/9/2018
Active	SilverScript Insurance Company	663526	Agent - Health	5/13/2020
Inactive	Southern Guaranty Insurance Company	969411	Agent - Health	8/9/2018	5/8/2023
Active	Tier One Insurance Company	301056	Agent - Health	10/24/2022
Active	Tier One Insurance Company	301056	Agent - Life	8/17/2022
Inactive	United World Life Insurance Company	300532	Agent - Health	6/15/2018	11/22/2022
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	8/8/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	8/8/2022	12/22/2022
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	8/15/2021	12/23/2021
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	8/8/2022
Inactive	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	6/16/2020	12/29/2021
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	6/16/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Designated Agent Company Inc.	681257	Agent - Life	6/12/2020
Active	Designated Agent Company Inc.	681257	Agent - Health	6/12/2020
Inactive	Health Iq Insurance Services, Inc	882220	Agent - Life	11/18/2019	9/20/2021
Inactive	Health Iq Insurance Services, Inc	882220	Agent - Health	11/18/2019	9/20/2021
Active	Medicare Complete	1342029	Agent - Life	5/24/2024
Active	Medicare Complete	1342029	Agent - Health	5/24/2024
Inactive	Qw Insurance Solutions, LLC	1047634	Agent - Health	6/10/2020	1/25/2023