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DEPARTMENT OF INSURANCE
Affiliations
Name
Sirotak, Jason E
DOIID
303269
NAIC NPN
2987741
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Active
Non Resident
Agent
Health
9/12/2023
6/30/2025
Active
Non Resident
Agent
Life
9/12/2023
6/30/2025
Active
Non Resident
Agent
Variable Life and Variable Annuities
9/12/2023
6/30/2025
* If a status Is
Pending, Pending Replacement
,Or the record displays
Affidavit On File
, click On them For more details.
Notice:
The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.
License Renewal Information
Class
Invoice Date
Response Due / Expiration Date
Response Received Date
Payment Received Date
Renewal Complete
Agent
04/15/2025
06/30/2025
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Aetna Health Inc.
300694
Agent - Health
3/20/2006
12/31/2007
Inactive
Aetna Health Inc. (PA)
660717
Agent - Health
12/31/2007
7/6/2017
Inactive
Aetna Life Insurance Company
301140
Agent - Health
3/20/2006
7/6/2017
Inactive
Aetna Life Insurance Company
301140
Agent - Life
3/20/2006
7/6/2017
Active
Anthem Health Plans of Kentucky, Inc.
300999
Agent - Health
3/4/2025
Inactive
Anthem Health Plans of New Hampshire, Inc.
944064
Agent - Health
9/26/2021
6/30/2023
Inactive
Anthem Insurance Companies, Inc.
300941
Agent - Health
9/26/2021
6/30/2023
Inactive
Brighthouse Life Insurance Company
301829
Agent - Health
7/31/2013
6/30/2023
Inactive
Brighthouse Life Insurance Company
301829
Agent - Life
7/31/2013
6/30/2023
Inactive
Brighthouse Life Insurance Company
301829
Agent - Variable Life and Variable Annuities
7/31/2013
6/30/2023
Inactive
CompBenefits Dental, Inc.
591692
Agent - Health
7/9/2010
7/20/2012
Inactive
Compcare Health Services Insurance Corporation
948751
Agent - Health
9/26/2021
6/30/2023
Inactive
Dental Concern Inc. (The)
301641
Agent - Health
3/21/2009
7/20/2012
Inactive
First Penn-Pacific Life Insurance Company
301581
Agent - Health
8/4/2000
12/23/2008
Inactive
First Penn-Pacific Life Insurance Company
301581
Agent - Life
8/4/2000
12/23/2008
Inactive
General American Life Insurance Company
300280
Agent - Health
6/7/2001
12/16/2009
Inactive
General American Life Insurance Company
300280
Agent - Life
6/7/2001
12/16/2009
Inactive
General American Life Insurance Company
300280
Agent - Variable Life and Variable Annuities
6/7/2001
12/16/2009
Inactive
Humana Health Plan, Inc.
300142
Agent - Health
3/20/2009
7/20/2012
Inactive
Humana Insurance Company
301104
Agent - Health
2/15/2006
7/20/2012
Inactive
Humana Insurance Company
301104
Agent - Life
2/15/2006
7/20/2012
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Health
2/15/2006
7/20/2012
Inactive
Humana Insurance Company of Kentucky
300826
Agent - Life
2/15/2006
7/20/2012
Inactive
Kanawha Insurance Company
300127
Agent - Health
4/11/2008
7/20/2012
Inactive
Kanawha Insurance Company
300127
Agent - Life
4/11/2008
7/20/2012
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Health
9/25/2019
5/2/2022
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Life
9/25/2019
5/2/2022
Inactive
Lincoln National Life Insurance Company (The)
301382
Agent - Variable Life and Variable Annuities
9/25/2019
5/2/2022
Inactive
Massachusetts Mutual Life Insurance Company
300445
Agent - Life
11/17/2020
6/30/2023
Inactive
MetLife Investors Insurance Company
301872
Agent - Health
4/21/2005
11/14/2014
Inactive
MetLife Investors Insurance Company
301872
Agent - Life
4/21/2005
11/14/2014
Inactive
MetLife Investors Insurance Company
301872
Agent - Variable Life and Variable Annuities
4/21/2005
11/14/2014
Inactive
MetLife Investors USA Insurance Company
300845
Agent - Life
4/21/2005
11/14/2014
Inactive
MetLife Investors USA Insurance Company
300845
Agent - Variable Life and Variable Annuities
2/23/2009
11/14/2014
Inactive
Metropolitan Life Insurance Company
301948
Agent - Health
11/8/1999
6/30/2023
Inactive
Metropolitan Life Insurance Company
301948
Agent - Life
11/8/1999
6/30/2023
Inactive
Metropolitan Life Insurance Company
301948
Agent - Variable Life and Variable Annuities
3/26/2012
6/30/2023
Inactive
New England Life Insurance Company
300343
Agent - Health
10/7/1999
6/30/2023
Inactive
New England Life Insurance Company
300343
Agent - Life
10/7/1999
6/30/2023
Inactive
New England Life Insurance Company
300343
Agent - Variable Life and Variable Annuities
5/31/2001
6/30/2023
Inactive
Paul Revere Life Insurance Company
300971
Agent - Health
3/24/2000
12/11/2002
Inactive
Paul Revere Life Insurance Company
300971
Agent - Life
3/24/2000
12/11/2002
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Health
3/24/2000
12/30/2009
Inactive
Provident Life and Accident Insurance Company
301525
Agent - Life
3/24/2000
12/30/2009
Inactive
UNUM Life Insurance Company of America
300817
Agent - Health
3/24/2000
12/30/2009
Inactive
UNUM Life Insurance Company of America
300817
Agent - Life
3/24/2000
12/30/2009
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Health
3/10/2006
11/30/2016
Inactive
UnitedHealthcare Insurance Company
300946
Agent - Life
3/10/2006
11/30/2016
Inactive
UnitedHealthcare of Kentucky, Ltd.
301337
Agent - Health
3/10/2006
11/30/2016
Inactive
UnitedHealthcare of Ohio, Inc.
300493
Agent - Health
3/10/2006
11/30/2016
Designated to act on behalf of the following Business Entities
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
CBISA Reaquisitian Corp
547026
Agent - Life
2/2/2006
6/30/2023
Inactive
CBISA Reaquisitian Corp
547026
Agent - Health
2/2/2006
6/30/2023
Inactive
Designated Agent Company Inc.
681257
Agent - Life
12/16/2013
6/30/2023
Inactive
Designated Agent Company Inc.
681257
Agent - Health
12/16/2013
6/30/2023
Denied
MML Insurance Agency LLC
398679
Agent - Life
Denied
MML Insurance Agency LLC
398679
Agent - Health
Denied
MML Insurance Agency LLC
398679
Agent - Variable Life and Variable Annuities
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