DEPARTMENT OF INSURANCE

Affiliations

Name	Jung, Sam S	DOIID	347267	NAIC NPN	2221560

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	8/24/1999		5/31/2027
Active	Non Resident	Agent	Property	7/3/2008		5/31/2027
Active	Non Resident	Agent	Life	8/24/1999		5/31/2027
Active	Non Resident	Agent	Casualty	7/3/2008		5/31/2027
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	5/31/2001	4/24/2025
* 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	03/15/2025	05/31/2025	04/24/2025	04/24/2025	Yes

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	8/3/2016
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	7/30/2020
Active	Aetna Life Insurance Company	301140	Agent - Health	8/3/2016
Active	Aetna Life Insurance Company	301140	Agent - Life	11/1/2016
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	2/15/2022	12/23/2024
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	2/4/2022	12/16/2024
Active	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019
Active	American Economy Insurance Company	300315	Agent - Property	11/9/2019
Inactive	American General Life Insurance Company	301585	Agent - Health	6/8/2011	10/25/2012
Inactive	American General Life Insurance Company	301585	Agent - Life	6/8/2011	10/25/2012
Active	Ameritas Life Insurance Corporation	300126	Agent - Health	10/18/2020
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	4/14/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/1/2004	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/1/2004	4/15/2025
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	5/6/2009	2/19/2010
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	5/6/2009	2/19/2010
Inactive	Banner Life Insurance Company	301696	Agent - Life	7/14/2011	8/21/2014
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	8/1/2017
Active	CIGNA Health & Life Insurance Company	301783	Agent - Life	8/1/2017
Active	CareSource Kentucky Co.	838179	Agent - Health	10/31/2019
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	9/6/2013	12/5/2014
Inactive	CompBenefits Insurance Company	301864	Agent - Health	9/12/2023	12/12/2024
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018	12/15/2020
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/11/2016	4/20/2018
Active	Devoted Health Insurance Company of Kentucky, Inc.	1306593	Agent - Health	7/3/2024
Active	First Health Life & Health Insurance Company	301735	Agent - Health	8/3/2016
Inactive	General American Life Insurance Company	300280	Agent - Health	8/14/2001	10/23/2006
Inactive	General American Life Insurance Company	300280	Agent - Life	8/14/2001	10/23/2006
Inactive	General American Life Insurance Company	300280	Agent - Variable Life and Variable Annuities	8/14/2001	10/23/2006
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	4/20/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	9/6/2013	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	9/6/2013	4/20/2018
Inactive	Humana Insurance Company	301104	Agent - Health	4/30/2018	12/10/2018
Inactive	Humana Insurance Company	301104	Agent - Life	4/30/2018	12/10/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	9/6/2013	4/20/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	9/6/2013	4/20/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	4/20/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	10/12/2016	4/20/2018
Inactive	HumanaDental Insurance Company	301457	Agent - Health	10/16/2007	9/8/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Life	10/16/2007	9/8/2010
Inactive	John Alden Life Insurance Company	300573	Agent - Health	2/23/2006	12/29/2008
Inactive	John Alden Life Insurance Company	300573	Agent - Life	2/23/2006	12/29/2008
Inactive	Kanawha Insurance Company	300127	Agent - Health	9/6/2013	12/5/2014
Inactive	Kanawha Insurance Company	300127	Agent - Life	9/6/2013	12/5/2014
Active	Life Insurance Company of the Southwest	301867	Agent - Life	2/18/2021
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	7/14/2008	10/8/2019
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	7/14/2008	10/8/2019
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Variable Life and Variable Annuities	7/14/2008	10/8/2019
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	10/14/2005	10/23/2006
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	10/14/2005	10/23/2006
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Variable Life and Variable Annuities	10/14/2005	10/23/2006
Inactive	Metropolitan Life Insurance Company	301948	Agent - Health	4/10/2008	2/10/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Life	4/10/2008	2/10/2012
Inactive	Metropolitan Life Insurance Company	301948	Agent - Variable Life and Variable Annuities	5/31/2001	10/23/2006
Active	National Health Insurance Company	300554	Agent - Health	3/22/2023
Active	National Health Insurance Company	300554	Agent - Life	3/22/2023
Inactive	National Western Life Insurance Company	301515	Agent - Life	12/22/2011	11/15/2019
Inactive	Protective Life Insurance Company	300638	Agent - Health	11/20/2008	11/23/2019
Inactive	Protective Life Insurance Company	300638	Agent - Life	11/20/2008	11/23/2019
Inactive	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities	11/20/2008	11/23/2019
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	7/18/2014
Active	SAFECO Insurance Company of America	300159	Agent - Property	7/18/2014
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	7/18/2014
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	7/18/2014
Active	SilverScript Insurance Company	663526	Agent - Health	8/23/2019
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	5/6/2009	2/19/2010
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	5/6/2009	2/19/2010
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	5/6/2009	2/19/2010
Inactive	The Phoenix Insurance Company	301502	Agent - Property	5/6/2009	2/19/2010
Inactive	Travelers Commercial Insurance Company	301506	Agent - Casualty	5/6/2009	2/19/2010
Inactive	Travelers Commercial Insurance Company	301506	Agent - Property	5/6/2009	2/19/2010
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	5/6/2009	2/19/2010
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	5/6/2009	2/19/2010
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	5/6/2009	2/19/2010
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	5/6/2009	2/19/2010
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	5/6/2009	2/19/2010
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	5/6/2009	2/19/2010
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	10/14/2014	7/26/2017
Inactive	UnitedHealthcare Insurance Company of America	301552	Agent - Health	9/15/2016	7/26/2017
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	10/14/2014	12/5/2016
Inactive	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	9/12/2015	7/26/2017
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	12/17/2019
Active	WellCare Health Plans of Kentucky, Inc.	838592	Agent - Health	10/8/2021
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	3/8/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	8/20/2004	6/23/2008
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	8/20/2004	6/23/2008
Active	Designated Agent Company Inc.	681257	Agent - Life	6/30/2008
Active	Designated Agent Company Inc.	681257	Agent - Health	6/30/2008