DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Jorgenson, Thomas Jason	DOIID	977372	NAIC NPN	17944072

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	11/22/2017	5/31/2021
Pending Replacement	Non Resident	Agent	Life	3/2/2022		5/31/2025
* 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	03/15/2025	05/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AAA Life Insurance Company	300287	Agent - Life	9/20/2023	3/4/2024
Inactive	American General Life Insurance Company	301585	Agent - Health	12/26/2017	5/31/2021
Inactive	American General Life Insurance Company	301585	Agent - Life	5/19/2024	5/24/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Health	2/2/2019	5/31/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Life	2/2/2019	5/31/2021
Inactive	Aspen American Insurance Company	301513	Agent - Health	12/18/2019	12/1/2020
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	3/16/2022	9/28/2022
Pending Replacement	Gerber Life Insurance Company	300529	Agent - Life	3/28/2023
Inactive	Globe Life and Accident Insurance Company	300639	Agent - Life	2/17/2023	12/13/2024
Inactive	Golden Rule Insurance Company	301943	Agent - Health	11/28/2017	5/6/2021
Inactive	Golden Rule Insurance Company	301943	Agent - Life	11/28/2017	5/6/2021
Inactive	LifeShield National Insurance Company	737111	Agent - Health	8/19/2019	5/31/2021
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	6/23/2022	4/21/2025
Inactive	Pruco Life Insurance Company	300954	Agent - Life	7/31/2023	3/26/2025
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	7/10/2023	3/28/2025
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	2/6/2023	3/17/2025

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	2/5/2019	5/31/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	2/5/2019	5/31/2021
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	9/10/2019	5/31/2021