DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Hollingsworth Jr, Jack Jones	DOIID	630987	NAIC NPN	1665319

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	4/27/2006	7/31/2011
Inactive	Non Resident	Agent	Health	4/27/2006	7/31/2011
* 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	CompBenefits Dental, Inc.	591692	Agent - Health	12/15/2010	7/31/2011
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	12/15/2010	7/31/2011
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/15/2010	7/31/2011
Inactive	Humana Insurance Company	301104	Agent - Health	12/15/2010	7/31/2011
Inactive	Humana Insurance Company	301104	Agent - Life	12/15/2010	7/31/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	12/15/2010	7/31/2011
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	12/15/2010	7/31/2011
Inactive	Kanawha Insurance Company	300127	Agent - Health	12/15/2010	7/31/2011
Inactive	Kanawha Insurance Company	300127	Agent - Life	12/15/2010	7/31/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Humana MarketPOINT Inc.	398092	Agent - Life	2/2/2011	7/31/2011
Inactive	Humana MarketPOINT Inc.	398092	Agent - Health	2/2/2011	7/31/2011
Denied	Regions Insurance, Inc.	502037	Agent - Life
Denied	Regions Insurance, Inc.	502037	Agent - Health