DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Ewertsen, Douglas	DOIID	785438	NAIC NPN	5710246

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	7/5/2012		9/30/2026
Active	Non Resident	Agent	Property	7/5/2012		9/30/2026
Active	Non Resident	Agent	Health	7/5/2012		9/30/2026
Active	Non Resident	Agent	Personal Lines	7/5/2012		9/30/2026
Active	Non Resident	Agent	Life	7/5/2012		9/30/2026
* 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	07/15/2026	09/30/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Brighthouse Life Insurance Company	301829	Agent - Life	11/14/2014	1/26/2018
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	10/17/2012	11/14/2014
Inactive	Protective Life Insurance Company	300638	Agent - Life	11/3/2012	11/23/2015
Inactive	Pruco Life Insurance Company	300954	Agent - Life	12/26/2012	12/23/2014
Inactive	Rural Community Insurance Company	301891	Agent - Casualty	5/27/2014	4/8/2016
Inactive	Rural Community Insurance Company	301891	Agent - Property	5/27/2014	4/8/2016
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	3/15/2016	11/30/2020
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	3/15/2016	11/30/2020
Inactive	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	3/15/2016	11/30/2020
Inactive	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	3/15/2016	4/30/2018
Active	Zurich American Insurance Company	301121	Agent - Casualty	3/16/2016
Active	Zurich American Insurance Company	301121	Agent - Property	3/16/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	3/23/2016	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	5/20/2014	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	5/27/2014	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Personal Lines	5/20/2014	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	5/27/2014	10/9/2019
Inactive	Usi Insurance Services LLC	669260	Agent - Health	12/27/2018	11/30/2020
Inactive	Usi Insurance Services LLC	669260	Agent - Life	12/27/2018	11/30/2020
Active	Usi Insurance Services LLC	669260	Agent - Property	12/27/2018
Active	Usi Insurance Services LLC	669260	Agent - Casualty	12/27/2018