DEPARTMENT OF INSURANCE

Affiliations

Name	Fortin, Joshua Standish	DOIID	512554	NAIC NPN	1963775

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Variable Life and Variable Annuities	3/27/2006	10/31/2024
Active	Non Resident	Agent	Life	3/27/2006	10/31/2024
Active	Non Resident	Agent	Health	3/27/2006	10/31/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	08/15/2024	10/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Accendo Insurance Company	300312	Agent - Life	6/10/2020
Active	Aetna Health Inc. (PA)	660717	Agent - Health	3/5/2009
Active	Aetna Life Insurance Company	301140	Agent - Health	3/5/2009
Active	Allianz Life Insurance Company of North America	301791	Agent - Life	2/9/2021
Active	Allianz Life Insurance Company of North America	301791	Agent - Variable Life and Variable Annuities	2/9/2021
Denied	American General Life Insurance Company of Delaware	301057	Agent - Health
Denied	American General Life Insurance Company of Delaware	301057	Agent - Life
Denied	American General Life Insurance Company of Delaware	301057	Agent - Variable Life and Variable Annuities
Inactive	Anthem Life Insurance Company	301209	Agent - Health	8/12/2009	11/3/2016
Inactive	Anthem Life Insurance Company	301209	Agent - Life	8/12/2009	11/3/2016
Inactive	Augustar Life Insurance Company	301816	Agent - Life	1/12/2018	12/28/2018
Inactive	Augustar Life Insurance Company	301816	Agent - Variable Life and Variable Annuities	1/12/2018	12/28/2018
Active	Banner Life Insurance Company	301696	Agent - Life	11/21/2022
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	8/6/2009	12/8/2015
Inactive	CompBenefits Insurance Company	301864	Agent - Health	8/6/2009	11/22/2011
Inactive	CompBenefits Insurance Company	301864	Agent - Life	8/6/2009	11/22/2011
Inactive	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	3/6/2018	12/15/2020
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	6/21/2010	12/8/2015
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	3/31/2006	3/9/2009
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Variable Life and Variable Annuities	3/31/2006	3/9/2009
Active	Forethought Life Insurance Company	301407	Agent - Health	7/16/2017
Active	Forethought Life Insurance Company	301407	Agent - Life	7/16/2017
Active	Forethought Life Insurance Company	301407	Agent - Variable Life and Variable Annuities	7/16/2017
Inactive	Genworth Life Insurance Company	300623	Agent - Health	10/6/2009	12/7/2012
Inactive	Genworth Life Insurance Company	300623	Agent - Life	10/6/2009	12/7/2012
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Health	6/26/2008	10/4/2009
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Life	6/26/2008	10/4/2009
Inactive	Genworth Life and Annuity Insurance Company	301276	Agent - Variable Life and Variable Annuities	3/31/2006	8/29/2006
Inactive	Guardian Insurance & Annuity Company Inc. (The)	301920	Agent - Life	9/19/2006	5/12/2009
Inactive	Guardian Insurance & Annuity Company Inc. (The)	301920	Agent - Variable Life and Variable Annuities	9/19/2006	5/12/2009
Inactive	Humana Benefit Plan of Illinois, Inc.	781543	Agent - Health	10/13/2014	6/15/2018
Inactive	Humana Health Plan of Ohio Inc.	301565	Agent - Health	10/10/2012	2/23/2018
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	8/6/2009	6/15/2018
Inactive	Humana Insurance Company	301104	Agent - Health	8/6/2009	6/15/2018
Inactive	Humana Insurance Company	301104	Agent - Life	8/6/2009	6/15/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Health	8/6/2009	6/15/2018
Inactive	Humana Insurance Company of Kentucky	300826	Agent - Life	8/6/2009	6/15/2018
Inactive	Humana Medical Plan, Inc.	801568	Agent - Health	10/13/2014	6/15/2018
Inactive	Humana Wisconsin Health Organization Insurance Corporation	830687	Agent - Health	11/10/2016	4/29/2019
Inactive	HumanaDental Insurance Company	301457	Agent - Health	8/6/2009	2/23/2012
Inactive	HumanaDental Insurance Company	301457	Agent - Life	8/6/2009	2/23/2012
Inactive	Jackson National Life Insurance Company	300486	Agent - Variable Life and Variable Annuities	10/23/2006	6/29/2011
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	1/17/2008	4/18/2012
Inactive	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Variable Life and Variable Annuities	1/17/2008	12/31/2010
Inactive	Kanawha Insurance Company	300127	Agent - Health	8/6/2009	10/22/2015
Inactive	Kanawha Insurance Company	300127	Agent - Life	8/6/2009	10/22/2015
Denied	Keyport Life Insurance Company	300319	Agent - Health
Denied	Keyport Life Insurance Company	300319	Agent - Life
Denied	Keyport Life Insurance Company	300319	Agent - Variable Life and Variable Annuities
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	7/6/2017
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	7/6/2017
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Variable Life and Variable Annuities	7/6/2017
Inactive	MetLife Investors Insurance Company	301872	Agent - Health	9/27/2006	3/14/2009
Inactive	MetLife Investors Insurance Company	301872	Agent - Life	9/27/2006	3/14/2009
Inactive	MetLife Investors Insurance Company	301872	Agent - Variable Life and Variable Annuities	9/27/2006	3/14/2009
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Health	9/27/2006	3/14/2009
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Life	9/27/2006	3/14/2009
Inactive	MetLife Investors USA Insurance Company	300845	Agent - Variable Life and Variable Annuities	9/27/2006	3/14/2009
Inactive	Nationwide Life Insurance Company	300495	Agent - Life	4/3/2006	11/16/2006
Inactive	Nationwide Life Insurance Company	300495	Agent - Variable Life and Variable Annuities	4/3/2006	11/16/2006
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Life	9/21/2006	8/1/2007
Inactive	New York Life Insurance and Annuity Corporation	300726	Agent - Variable Life and Variable Annuities	9/21/2006	8/1/2007
Inactive	Protective Life Insurance Company	300638	Agent - Health	9/19/2006	11/23/2009
Inactive	Protective Life Insurance Company	300638	Agent - Life	9/19/2006	11/23/2009
Inactive	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities	9/19/2006	11/23/2009
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	1/26/2009	3/30/2009
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	4/3/2006	3/30/2009
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Variable Life and Variable Annuities	4/3/2006	3/30/2009
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	1/26/2009	3/30/2009
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	4/3/2006	3/30/2009
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Variable Life and Variable Annuities	4/3/2006	3/30/2009
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	4/3/2006	8/26/2008
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Variable Life and Variable Annuities	4/3/2006	8/26/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	8/12/2009	11/2/2016
Inactive	Designated Agent Company Inc.	681257	Agent - Health	8/12/2009	11/2/2016
Denied	Ubs Financial Services Ins Agency Inc	399373	Agent - Life
Denied	Ubs Financial Services Ins Agency Inc	399373	Agent - Health
Denied	Ubs Financial Services Ins Agency Inc	399373	Agent - Variable Life and Variable Annuities
Inactive	Whitehall Financial Services Inc	677246	Agent - Life	4/21/2008	3/31/2018
Inactive	Whitehall Financial Services Inc	677246	Agent - Health	4/21/2008	3/31/2018