DEPARTMENT OF INSURANCE

Affiliations

Name	Hermsen, David Lee	DOIID	360759	NAIC NPN	547477

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Life	9/22/2011	3/1/2016
Inactive	Resident	Agent	General Lines	7/10/1991	10/19/1998
Inactive	Resident	Agent	Casualty	12/8/2006	3/1/2010
Inactive	Resident	Agent	Health	12/31/1991	3/1/2010
Inactive	Resident	Agent	Property	12/8/2006	3/1/2010
Inactive	Resident	Agent	Health Maintenance Organization	11/10/1998	3/1/2001
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	5/26/2006	10/16/2008
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	5/26/2006	10/16/2008
Inactive	American Equity Investment Life Insurance Company	300389	Agent - Life	5/2/2006	1/18/2010
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	12/20/2006	10/9/2009
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	12/20/2006	10/9/2009
Inactive	American General Life Insurance Company	301585	Agent - Health	12/7/2006	3/1/2010
Inactive	American General Life Insurance Company	301585	Agent - Life	12/7/2006	3/1/2010
Inactive	American Memorial Life Insurance Company	301445	Agent - Life	11/30/2011	12/15/2014
Inactive	Athene Annuity and Life Company	301893	Agent - Life	12/10/2008	12/4/2009
Inactive	Banner Life Insurance Company	301696	Agent - Life	4/3/2000	3/1/2010
Inactive	Clarica Life Insurance Company - U.S.	300207	Agent - Health	5/17/1996	3/31/1997
Inactive	Clarica Life Insurance Company - U.S.	300207	Agent - Life	5/17/1996	3/31/1997
Inactive	Continental Casualty Company	301019	Agent - General Lines	3/7/1995	10/19/1998
Inactive	Encova Life Insurance Company	301818	Agent - Life	9/16/2008	3/1/2010
Inactive	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	7/25/2006	3/10/2009
Inactive	First Colony Life Insurance Company	301179	Agent - Health	5/14/2003	1/1/2007
Inactive	First Colony Life Insurance Company	301179	Agent - Life	5/14/2003	1/1/2007
Inactive	Genworth Life Insurance Company	300623	Agent - Health	11/29/2007	3/1/2010
Inactive	Genworth Life Insurance Company	300623	Agent - Life	11/29/2007	3/1/2010
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	1/1/2007	3/1/2010
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	1/1/2007	3/1/2010
Inactive	Golden Rule Insurance Company	301943	Agent - Health	12/31/1991	3/31/1997
Inactive	Golden Rule Insurance Company	301943	Agent - Life	12/31/1991	3/31/1997
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health Maintenance Organization	11/10/1998	1/28/1999
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/9/2008	3/1/2010
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	12/31/1998	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	12/9/2008	3/1/2010
Inactive	Humana Insurance Company	301104	Agent - Life	12/9/2008	3/1/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/9/2008	3/1/2010
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/9/2008	3/1/2010
Inactive	HumanaDental Insurance Company	301457	Agent - Health	9/26/2006	11/9/2006
Inactive	HumanaDental Insurance Company	301457	Agent - Life	9/26/2006	11/9/2006
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Health	12/19/2008	3/1/2010
Inactive	Illinois Mutual Life Insurance Company	301479	Agent - Life	12/19/2008	3/1/2010
Inactive	Integrity Life Insurance Company	301687	Agent - Life	7/27/2006	12/3/2008
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	1/18/1995	4/30/1997
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	1/18/1995	4/30/1997
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/9/2008	3/1/2010
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/9/2008	3/1/2010
Inactive	Lincoln Heritage Life Insurance Company	500016	Agent - Life	3/24/2015	9/11/2015
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Health	2/22/1999	3/1/2010
Inactive	Lincoln National Life Insurance Company (The)	301382	Agent - Life	2/22/1999	3/1/2010
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	7/17/2006	7/10/2008
Inactive	North American Company for Life and Health Insurance	300291	Agent - Life	11/12/1999	10/18/2005
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Health	4/28/2006	3/1/2010
Inactive	PacifiCare Life and Health Insurance Company	301304	Agent - Life	4/28/2006	3/1/2010
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	5/10/1996	10/19/1998
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	5/10/1996	10/19/1998
Inactive	Reassure America Life Insurance Company	301902	Agent - Health	2/17/1999	1/2/2003
Inactive	Reassure America Life Insurance Company	301902	Agent - Life	6/18/2003	9/16/2004
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Health	11/17/1992	10/19/1998
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Life	11/17/1992	10/19/1998
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Health	5/1/1996	3/31/1997
Inactive	Senior Health Insurance Company of Pennsylvania	300251	Agent - Life	5/1/1996	3/31/1997
Inactive	Standard Insurance Company	300185	Agent - Health	10/29/2007	3/1/2010
Inactive	Standard Insurance Company	300185	Agent - Life	10/29/2007	3/1/2010
Inactive	State Automobile Mutual Insurance Company	301824	Agent - General Lines	7/10/1991	3/31/1996
Inactive	Time Insurance Company	300683	Agent - Health	6/6/2006	12/29/2008
Inactive	Time Insurance Company	300683	Agent - Life	6/6/2006	12/29/2008
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	12/1/2008	3/1/2010
Inactive	United Home Life Insurance Company	300421	Agent - Life	11/14/2008	3/1/2010
Inactive	United World Life Insurance Company	300532	Agent - Health	7/17/2006	7/10/2008
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	12/20/1995	10/19/1998
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	12/20/1995	10/19/1998
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Health	7/2/1996	3/31/1997
Inactive	UnitedHealthcare Life Insurance Company	301517	Agent - Life	7/2/1996	3/31/1997
Inactive	West Coast Life Insurance Company	301607	Agent - Health	11/1/2007	3/1/2010
Inactive	West Coast Life Insurance Company	301607	Agent - Life	11/1/2007	3/1/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Acordia of Louisville Inc.	401252	Agent - Life	5/26/1994	10/19/1998
Inactive	Acordia of Louisville Inc.	401252	Agent - Health	5/26/1994	10/19/1998
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/25/1996	10/19/1998
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/25/1996	10/19/1998