DEPARTMENT OF INSURANCE

Affiliations

Name	Coffman, Matthew S	DOIID	591982	NAIC NPN	8158905

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Property	7/25/2005	4/30/2025
Active	Resident	Agent	Casualty	7/25/2005	4/30/2025
Active	Resident	Agent	Life	2/13/2006	4/30/2025
Active	Resident	Agent	Variable Life and Variable Annuities	4/29/2011	4/30/2025
Active	Resident	Agent	Health	2/13/2006	4/30/2025
* 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

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Allstate Indemnity Company	300778	Agent - Casualty	8/17/2005
Active	Allstate Indemnity Company	300778	Agent - Property	8/17/2005
Active	Allstate Insurance Company	300773	Agent - Casualty	8/17/2005
Active	Allstate Insurance Company	300773	Agent - Property	8/17/2005
Active	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	8/12/2005
Active	Allstate Property and Casualty Insurance Company	300593	Agent - Property	8/12/2005
Active	Allstate Vehicle & Property Insurance Company	301429	Agent - Casualty	2/19/2014
Active	Allstate Vehicle & Property Insurance Company	301429	Agent - Property	2/19/2014
Active	American Family Home Insurance Company	301817	Agent - Casualty	4/29/2024
Active	American Family Home Insurance Company	301817	Agent - Property	4/29/2024
Active	American Heritage Life Insurance Company	300272	Agent - Health	12/16/2014
Active	American Heritage Life Insurance Company	300272	Agent - Life	12/16/2014
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	5/9/2019
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	5/9/2019
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	6/16/2015	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	6/16/2015	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	6/17/2015	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	6/17/2015	11/14/2021
Inactive	Anthem Life Insurance Company	301209	Agent - Health	3/1/2016	12/10/2020
Inactive	Anthem Life Insurance Company	301209	Agent - Life	3/1/2016	12/10/2020
Inactive	CompBenefits Dental, Inc.	591692	Agent - Health	3/2/2016	4/8/2017
Inactive	Dental Concern Inc. (The)	301641	Agent - Health	3/2/2016	4/8/2017
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	9/8/2014	12/17/2018
Active	Equitable Financial Life Insurance Company	300808	Agent - Variable Life and Variable Annuities	9/8/2014
Inactive	Esurance Property and Casualty Insurance Company	613279	Agent - Casualty	7/16/2021	3/8/2023
Inactive	Esurance Property and Casualty Insurance Company	613279	Agent - Property	7/16/2021	3/8/2023
Active	Everlake Assurance Company	300203	Agent - Life	12/17/2014
Active	Everlake Assurance Company	300203	Agent - Variable Life and Variable Annuities	12/17/2014
Active	Everlake Life Insurance Company	300873	Agent - Health	3/6/2006
Active	Everlake Life Insurance Company	300873	Agent - Life	3/6/2006
Active	Everlake Life Insurance Company	300873	Agent - Variable Life and Variable Annuities	5/6/2011
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	10/8/2023
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	10/8/2023
Inactive	Gerber Life Insurance Company	300529	Agent - Health	1/5/2018	10/3/2023
Inactive	Gerber Life Insurance Company	300529	Agent - Life	1/5/2018	10/3/2023
Inactive	Golden Rule Insurance Company	301943	Agent - Health	11/22/2011	8/12/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Life	11/22/2011	8/12/2015
Inactive	Humana Insurance Company	301104	Agent - Health	3/2/2016	4/8/2017
Inactive	Humana Insurance Company	301104	Agent - Life	3/2/2016	4/8/2017
Active	Integon Indemnity Corporation	300674	Agent - Casualty	9/9/2022
Active	Integon Indemnity Corporation	300674	Agent - Property	9/9/2022
Active	Lincoln Benefit Life Company	301110	Agent - Health	5/4/2009
Active	Lincoln Benefit Life Company	301110	Agent - Life	5/4/2009
Active	Lincoln Benefit Life Company	301110	Agent - Variable Life and Variable Annuities	5/6/2011
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	4/7/2021
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Variable Life and Variable Annuities	4/7/2021
Active	Midland National Life Insurance Company	300923	Agent - Life	6/9/2024
Active	Midland National Life Insurance Company	300923	Agent - Variable Life and Variable Annuities	6/9/2024
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	5/15/2018	4/22/2019
Active	Pacific Life Insurance Company	301848	Agent - Life	10/21/2020
Inactive	Pacific Specialty Insurance Company	301846	Agent - Casualty	4/5/2012	4/16/2019
Inactive	Pacific Specialty Insurance Company	301846	Agent - Property	4/5/2012	4/16/2019
Active	Principal National Life Insurance Company	301926	Agent - Life	7/30/2021
Active	Protective Life Insurance Company	300638	Agent - Health	3/6/2019
Active	Protective Life Insurance Company	300638	Agent - Life	3/6/2019
Active	Protective Life Insurance Company	300638	Agent - Variable Life and Variable Annuities	3/6/2019
Active	Pruco Life Insurance Company	300954	Agent - Health	5/5/2011
Active	Pruco Life Insurance Company	300954	Agent - Life	5/5/2011
Active	Pruco Life Insurance Company	300954	Agent - Variable Life and Variable Annuities	5/5/2011
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Health	2/4/2015	4/6/2018
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	2/4/2015	4/6/2018
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Variable Life and Variable Annuities	2/4/2015	4/6/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Coffman Insurance Agency, LLC	522245	Agent - Casualty	5/1/2006
Active	Coffman Insurance Agency, LLC	522245	Agent - Property	5/1/2006
Active	Coffman Insurance Agency, LLC	522245	Agent - Health	5/1/2006
Active	Coffman Insurance Agency, LLC	522245	Agent - Life	5/1/2006
Inactive	Designated Agent Company Inc.	681257	Agent - Health	3/1/2016	12/13/2020
Inactive	Designated Agent Company Inc.	681257	Agent - Life	3/1/2016	12/13/2020
Inactive	J.T. Coffman, LLC	522247	Agent - Casualty	5/1/2006	5/29/2009
Inactive	J.T. Coffman, LLC	522247	Agent - Property	5/1/2006	5/29/2009
Inactive	J.T. Coffman, LLC	522247	Agent - Health	5/1/2006	5/29/2009
Inactive	J.T. Coffman, LLC	522247	Agent - Life	5/1/2006	5/29/2009