DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bushur, Jacob Thomas	DOIID	978922	NAIC NPN	18511273

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	12/9/2017		11/30/2024
Active	Non Resident	Agent	Life	12/9/2017		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
Active	Freedom Life Insurance Company of America	300074	Agent - Health	12/13/2017
Active	Freedom Life Insurance Company of America	300074	Agent - Life	12/13/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Ushealth Advisors Llc	713288	Agent - Life	12/13/2017
Active	Ushealth Advisors Llc	713288	Agent - Health	12/13/2017