DEPARTMENT OF INSURANCE

Affiliations

Name	Ervin, Tristian	DOIID	1242262	NAIC NPN	20337008

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	11/14/2022	11/30/2024
Active	Non Resident	Agent	Life	11/14/2022	11/30/2024
* 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	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Accendo Insurance Company	300312	Agent - Health	7/19/2023	11/17/2023
Active	Aetna Health Inc. (PA)	660717	Agent - Health	11/17/2022
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	12/1/2022
Active	Aetna Health of Ohio Inc.	1065035	Agent - Health	11/17/2022
Active	Aetna Life Insurance Company	301140	Agent - Health	11/17/2022
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	11/14/2022
Active	Anthem Health Plans of New Hampshire, Inc.	944064	Agent - Health	11/14/2022
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	11/14/2022
Active	CIGNA Health & Life Insurance Company	301783	Agent - Health	11/29/2022
Active	Care Improvement Plus South Central Insurance Company	799697	Agent - Health	11/15/2022
Active	Chesapeake Life Insurance Company (The)	301017	Agent - Health	8/23/2023
Active	Chesapeake Life Insurance Company (The)	301017	Agent - Life	8/23/2023
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	11/14/2022
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	12/1/2022
Active	Golden Rule Insurance Company	301943	Agent - Health	4/11/2024
Active	Golden Rule Insurance Company	301943	Agent - Life	4/11/2024
Active	Guardian Life Insurance Company of America	301316	Agent - Health	12/2/2022
Active	Guardian Life Insurance Company of America	301316	Agent - Life	12/2/2022
Active	Monitor Life Insurance Company of New York	1117550	Agent - Health	1/31/2023
Active	Monitor Life Insurance Company of New York	1117550	Agent - Life	1/31/2023
Active	SilverScript Insurance Company	663526	Agent - Health	11/17/2022
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	11/15/2022
Inactive	UnitedHealthcare Insurance Company of the River Valley	1027817	Agent - Health	11/15/2022	12/22/2022
Active	UnitedHealthcare of Wisconsin, Inc.	871491	Agent - Health	11/15/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Extend Insurance Services, LLC	625753	Agent - Life	12/2/2022
Active	Extend Insurance Services, LLC	625753	Agent - Health	12/1/2022