DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Jacobson, Teresa	DOIID	535899	NAIC NPN	7219032

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Health	2/25/2010	12/1/2013
Inactive	Resident	Agent	Life	2/25/2010	12/1/2013
* 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	Chase Insurance Life and Annuity Company	300518	Agent - Health	11/13/2001	4/1/2007
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	12/11/2001	4/1/2007
Inactive	Protective Life Insurance Company	300638	Agent - Health	4/1/2007	11/30/2009
Inactive	Protective Life Insurance Company	300638	Agent - Life	4/1/2007	11/30/2009
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	7/20/2010	12/1/2013
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	7/20/2010	12/1/2013
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/20/2010	12/1/2013
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	7/20/2010	12/1/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Business Benefits Inc	400111	Agent - Life	8/31/2010	12/1/2013
Inactive	Business Benefits Inc	400111	Agent - Health	8/31/2010	12/1/2013