DEPARTMENT OF INSURANCE
Affiliations
NameTriad Insurance IncDOIID512953NAIC NPN2110595
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentHealth8/10/2000 3/31/2026
ActiveNon ResidentAgentLife8/10/2000 3/31/2026
ActiveNon ResidentAgentVariable Life and Variable Annuities3/29/2001 3/31/2026
* 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.

Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAllianz Life Insurance Company of North America301791Agent - Health8/27/2001 
ActiveAllianz Life Insurance Company of North America301791Agent - Life8/27/2001 
ActiveAllianz Life Insurance Company of North America301791Agent - Variable Life and Variable Annuities8/27/2001 
InactiveAmerican Enterprise Life Insurance Company300262Agent - Life11/2/200512/31/2006
InactiveAmerican Enterprise Life Insurance Company300262Agent - Variable Life and Variable Annuities11/2/200512/31/2006
ActiveAmerican General Life Insurance Company301585Agent - Life12/17/2012 
ActiveAmerican General Life Insurance Company301585Agent - Variable Life and Variable Annuities12/17/2012 
ActiveAmerican United Life Insurance Company300498Agent - Health4/13/2022 
ActiveAmerican United Life Insurance Company300498Agent - Life4/13/2022 
ActiveAmerican United Life Insurance Company300498Agent - Variable Life and Variable Annuities4/13/2022 
InactiveAmeritas Life Insurance Corporation300126Agent - Life4/9/200712/30/2016
InactiveAmeritas Life Insurance Corporation300126Agent - Variable Life and Variable Annuities4/9/200712/30/2016
InactiveAmeritas Variable Life Insurance Company300665Agent - Life1/16/20035/1/2007
InactiveAmeritas Variable Life Insurance Company300665Agent - Variable Life and Variable Annuities1/16/20035/1/2007
ActiveBanner Life Insurance Company301696Agent - Life10/7/2003 
ActiveBrighthouse Life Insurance Company301829Agent - Life7/29/2002 
ActiveBrighthouse Life Insurance Company301829Agent - Variable Life and Variable Annuities7/29/2002 
ActiveC.M. Life Insurance Company301335Agent - Health9/15/2003 
ActiveC.M. Life Insurance Company301335Agent - Life9/15/2003 
ActiveC.M. Life Insurance Company301335Agent - Variable Life and Variable Annuities9/15/2003 
ActiveDelaware Life Insurance Company301256Agent - Life3/7/2003 
ActiveDelaware Life Insurance Company301256Agent - Variable Life and Variable Annuities3/7/2003 
ActiveEmpower Annuity Insurance Company of America300259Agent - Life1/21/2016 
ActiveEmpower Annuity Insurance Company of America300259Agent - Variable Life and Variable Annuities1/21/2016 
InactiveEquitable Financial Life Insurance Company300808Agent - Life6/7/200212/21/2018
ActiveEquitable Financial Life Insurance Company300808Agent - Variable Life and Variable Annuities6/7/2002 
InactiveEquitable Financial Life Insurance Company of America301772Agent - Health4/30/201412/18/2018
ActiveEquitable Financial Life Insurance Company of America301772Agent - Life5/27/2022 
ActiveEquitable Financial Life Insurance Company of America301772Agent - Variable Life and Variable Annuities5/27/2022 
ActiveEverlake Life Insurance Company300873Agent - Life4/15/2004 
ActiveEverlake Life Insurance Company300873Agent - Variable Life and Variable Annuities4/15/2004 
InactiveFidelity & Guaranty Life Insurance Company301359Agent - Health8/12/200412/20/2012
InactiveFidelity & Guaranty Life Insurance Company301359Agent - Life8/12/200412/20/2012
InactiveFirst Colony Life Insurance Company301179Agent - Health10/10/200312/20/2006
InactiveFirst Colony Life Insurance Company301179Agent - Life10/10/200312/20/2006
ActiveForethought Life Insurance Company301407Agent - Health5/20/2013 
ActiveForethought Life Insurance Company301407Agent - Life5/20/2013 
ActiveForethought Life Insurance Company301407Agent - Variable Life and Variable Annuities5/20/2013 
InactiveFortitude Life Insurance & Annuity Company301503Agent - Health9/5/200011/22/2011
ActiveFortitude Life Insurance & Annuity Company301503Agent - Life9/5/2000 
ActiveFortitude Life Insurance & Annuity Company301503Agent - Variable Life and Variable Annuities4/13/2001 
InactiveGeneral American Life Insurance Company300280Agent - Health4/21/200912/16/2009
InactiveGeneral American Life Insurance Company300280Agent - Life4/21/200912/16/2009
InactiveGeneral American Life Insurance Company300280Agent - Variable Life and Variable Annuities4/21/200912/16/2009
InactiveGenworth Life and Annuity Insurance Company301276Agent - Health5/22/200212/7/2012
InactiveGenworth Life and Annuity Insurance Company301276Agent - Life5/22/200212/7/2012
InactiveGenworth Life and Annuity Insurance Company301276Agent - Variable Life and Variable Annuities4/16/200312/7/2012
InactiveGlenbrook Life and Annuity Company301384Agent - Life4/15/20041/1/2005
InactiveGlenbrook Life and Annuity Company301384Agent - Variable Life and Variable Annuities4/15/20041/1/2005
InactiveGuardian Insurance & Annuity Company Inc. (The)301920Agent - Life12/5/200310/5/2021
InactiveGuardian Insurance & Annuity Company Inc. (The)301920Agent - Variable Life and Variable Annuities12/5/200310/5/2021
ActiveJackson National Life Insurance Company300486Agent - Life4/1/2005 
ActiveJackson National Life Insurance Company300486Agent - Variable Life and Variable Annuities4/1/2005 
InactiveJohn Hancock Life Insurance Company300821Agent - Health8/14/200712/30/2009
InactiveJohn Hancock Life Insurance Company300821Agent - Life8/14/200712/30/2009
ActiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Health8/15/2007 
ActiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life8/15/2007 
ActiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Variable Life and Variable Annuities9/13/2011 
InactiveJohn Hancock Variable Life Insurance Company301914Agent - Life9/29/20006/26/2007
InactiveLincoln Benefit Life Company301110Agent - Health12/3/20037/14/2014
InactiveLincoln Benefit Life Company301110Agent - Life12/3/20037/14/2014
InactiveLincoln Benefit Life Company301110Agent - Variable Life and Variable Annuities12/3/20037/14/2014
ActiveLincoln National Life Insurance Company (The)301382Agent - Health8/31/2000 
ActiveLincoln National Life Insurance Company (The)301382Agent - Life8/31/2000 
ActiveLincoln National Life Insurance Company (The)301382Agent - Variable Life and Variable Annuities4/12/2001 
InactiveManufacturers Life Insurance Company of North America301899Agent - Life10/23/20001/22/2002
ActiveMassachusetts Mutual Life Insurance Company300445Agent - Health9/15/2003 
ActiveMassachusetts Mutual Life Insurance Company300445Agent - Life9/15/2003 
ActiveMassachusetts Mutual Life Insurance Company300445Agent - Variable Life and Variable Annuities9/15/2003 
InactiveMetLife Investors Insurance Company301872Agent - Life2/9/200111/14/2014
InactiveMetLife Investors Insurance Company301872Agent - Variable Life and Variable Annuities3/24/200911/14/2014
InactiveMetLife Investors USA Insurance Company300845Agent - Health3/14/200611/14/2009
InactiveMetLife Investors USA Insurance Company300845Agent - Life11/20/200911/14/2014
InactiveMetLife Investors USA Insurance Company300845Agent - Variable Life and Variable Annuities12/8/200911/14/2014
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Life7/29/200212/7/2007
InactiveMetLife Life and Annuity Company of Connecticut301593Agent - Variable Life and Variable Annuities7/29/200212/7/2007
ActiveMetropolitan Life Insurance Company301948Agent - Health3/26/2009 
ActiveMetropolitan Life Insurance Company301948Agent - Life3/26/2009 
ActiveMetropolitan Life Insurance Company301948Agent - Variable Life and Variable Annuities3/26/2009 
ActiveMidland National Life Insurance Company300923Agent - Life1/23/2019 
ActiveMidland National Life Insurance Company300923Agent - Variable Life and Variable Annuities1/23/2019 
InactiveNassau Life Insurance Company301406Agent - Life7/28/20037/22/2011
InactiveNassau Life Insurance Company301406Agent - Variable Life and Variable Annuities7/28/20037/22/2011
ActiveNationwide Life Insurance Company300495Agent - Health8/10/2000 
ActiveNationwide Life Insurance Company300495Agent - Life8/10/2000 
ActiveNationwide Life Insurance Company300495Agent - Variable Life and Variable Annuities3/29/2001 
ActiveNationwide Life and Annuity Insurance Company300714Agent - Health10/25/2012 
ActiveNationwide Life and Annuity Insurance Company300714Agent - Life10/25/2012 
ActiveNationwide Life and Annuity Insurance Company300714Agent - Variable Life and Variable Annuities10/25/2012 
InactiveNew England Life Insurance Company300343Agent - Health4/21/200912/10/2009
InactiveNew England Life Insurance Company300343Agent - Life4/21/200912/10/2009
InactiveNew England Life Insurance Company300343Agent - Variable Life and Variable Annuities4/21/200912/10/2009
ActiveNew York Life Insurance and Annuity Corporation300726Agent - Life10/3/2011 
ActiveNew York Life Insurance and Annuity Corporation300726Agent - Variable Life and Variable Annuities10/3/2011 
InactivePHL Variable Insurance Company300525Agent - Life7/28/20031/4/2013
InactivePHL Variable Insurance Company300525Agent - Variable Life and Variable Annuities7/28/20031/4/2013
ActivePacific Life Insurance Company301848Agent - Health4/6/2012 
ActivePacific Life Insurance Company301848Agent - Life6/20/2002 
ActivePacific Life Insurance Company301848Agent - Variable Life and Variable Annuities6/20/2002 
ActivePrincipal Life Insurance Company300129Agent - Health4/4/2012 
ActivePrincipal Life Insurance Company300129Agent - Life4/4/2012 
ActivePrincipal Life Insurance Company300129Agent - Variable Life and Variable Annuities4/4/2012 
InactiveProtective Life Insurance Company300638Agent - Life1/1/200712/22/2010
ActivePruco Life Insurance Company300954Agent - Life7/17/2001 
ActivePruco Life Insurance Company300954Agent - Variable Life and Variable Annuities7/17/2001 
ActivePrudential Insurance Company of America300784Agent - Health7/17/2001 
ActivePrudential Insurance Company of America300784Agent - Life7/17/2001 
ActivePrudential Insurance Company of America300784Agent - Variable Life and Variable Annuities7/17/2001 
InactiveRiverSource Life Insurance Company301952Agent - Life12/31/200612/30/2008
InactiveRiverSource Life Insurance Company301952Agent - Variable Life and Variable Annuities12/31/200612/30/2008
InactiveSunAmerica Annuity and Life Assurance Company301930Agent - Life9/14/200012/31/2012
InactiveSunAmerica Annuity and Life Assurance Company301930Agent - Variable Life and Variable Annuities1/20/201012/31/2012
InactiveSunAmerica Life Insurance Company300096Agent - Life12/31/201212/31/2012
InactiveSunAmerica Life Insurance Company300096Agent - Variable Life and Variable Annuities12/31/201212/31/2012
ActiveTalcott Resolution Life Insurance Company301759Agent - Health9/29/2000 
ActiveTalcott Resolution Life Insurance Company301759Agent - Life9/29/2000 
ActiveTalcott Resolution Life Insurance Company301759Agent - Variable Life and Variable Annuities6/13/2001 
ActiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Health9/29/2000 
ActiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Life9/29/2000 
ActiveTalcott Resolution Life and Annuity Insurance Company300932Agent - Variable Life and Variable Annuities6/13/2001 
InactiveTransamerica Financial Life Insurance Company301288Agent - Health7/1/20153/8/2017
InactiveTransamerica Financial Life Insurance Company301288Agent - Life7/1/20153/8/2017
InactiveTransamerica Financial Life Insurance Company301288Agent - Variable Life and Variable Annuities7/1/20153/8/2017
ActiveTransamerica Life Insurance Company300571Agent - Life3/24/2009 
ActiveTransamerica Life Insurance Company300571Agent - Variable Life and Variable Annuities3/24/2009 
InactiveTransamerica Premier Life Insurance Company300558Agent - Life3/22/201010/1/2020
InactiveTransamerica Premier Life Insurance Company300558Agent - Variable Life and Variable Annuities3/22/201010/1/2020
InactiveUnited of Omaha Life Insurance Company300156Agent - Health10/14/200310/15/2007
InactiveUnited of Omaha Life Insurance Company300156Agent - Life10/14/200310/15/2007
InactiveVenerable Insurance and Annuity Company301006Agent - Life6/1/20045/18/2018
ActiveVoya Retirement Insurance and Annuity Company300643Agent - Life10/26/2009 
InactiveWest Coast Life Insurance Company301607Agent - Life10/10/200312/29/2005
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Health9/19/200810/28/2010
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Life9/19/200810/28/2010
InactiveWestern Reserve Life Assurance Company of Ohio300760Agent - Variable Life and Variable Annuities9/19/200810/28/2010
Inactive300277Agent - Life10/10/20031/1/2007
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBach, Christopher Sandaas 512914Agent - Health8/10/200012/30/2002
InactiveBach, Christopher Sandaas 512914Agent - Life8/10/20003/7/2003
InactiveBach, Christopher Sandaas 512914Agent - Variable Life and Variable Annuities3/29/20013/7/2003
InactiveBasevitz, Alan Leslie 375134Agent - Health5/24/20017/1/2002
InactiveBasevitz, Alan Leslie 375134Agent - Life5/24/20017/1/2002
InactiveBasevitz, Alan Leslie 375134Agent - Variable Life and Variable Annuities5/24/20017/1/2002
InactiveBruderman, Robert William 503077Agent - Life8/10/200011/30/2011
InactiveBruderman, Robert William 503077Agent - Variable Life and Variable Annuities3/30/200111/30/2011
InactiveBuckley, Charles Kelly 328558Agent - Health2/18/20035/4/2006
InactiveBuckley, Charles Kelly 328558Agent - Life2/18/20035/4/2006
InactiveBuckley, Charles Kelly 328558Agent - Variable Life and Variable Annuities2/18/20035/4/2006
InactiveDedman, David A 371696Agent - Health3/7/20034/28/2018
InactiveDedman, David A 371696Agent - Life3/7/200311/30/2022
InactiveDedman, David A 371696Agent - Variable Life and Variable Annuities3/7/200311/30/2022
InactiveFrick, Jennifer Suzette 354334Agent - Life5/24/20011/22/2003
InactiveFrick, Jennifer Suzette 354334Agent - Variable Life and Variable Annuities5/24/20011/22/2003
ActiveKaplan, Albert H 386607Agent - Health5/24/2001 
ActiveKaplan, Albert H 386607Agent - Life5/24/2001 
ActiveKaplan, Albert H 386607Agent - Variable Life and Variable Annuities5/24/2001 
InactiveStarks, Katherine Brown 504377Agent - Life7/16/201210/31/2021
InactiveStarks, Katherine Brown 504377Agent - Variable Life and Variable Annuities7/18/201212/17/2020
InactiveThompson, Kristina L. 537242Agent - Health3/7/200312/5/2005
InactiveThompson, Kristina L. 537242Agent - Life3/7/200312/5/2005
InactiveThompson, Kristina L. 537242Agent - Variable Life and Variable Annuities3/7/200312/5/2005
InactiveWoods, Joseph P 302623Agent - Health1/29/20035/4/2006
InactiveWoods, Joseph P 302623Agent - Life1/29/20035/4/2006
InactiveWoods, Joseph P 302623Agent - Variable Life and Variable Annuities1/29/20035/4/2006

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