DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Terry, Jason	DOIID	618931	NAIC NPN	8513658

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Health	10/11/2021		5/31/2025
Pending Replacement	Non Resident	Agent	Life	4/27/2023		5/31/2025
* 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	03/15/2025	05/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	10/30/2013	6/7/2019
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	9/9/2009	5/31/2011
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	10/11/2021	4/8/2024
Inactive	Continental American Insurance Company	301700	Agent - Health	11/8/2013	5/31/2019
Inactive	Golden Rule Insurance Company	301943	Agent - Health	10/27/2021	3/17/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Paychex Insurance Agency Inc	509469	Agent - Health	5/1/2023	4/8/2024
Denied	Paychex Insurance Agency Inc	509469	Agent - Life