PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameEthos Technologies Inc.
DBA : ETHOS LIFE INSURANCE SERVICES		DOIID934675NAIC NPN18166550
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAdministratorNot Applicable5/8/2019 3/31/2026
ActiveNon ResidentAgentLife10/26/2016 3/31/2026
ActiveNon ResidentAgentHealth3/22/2021 3/31/2026
InactiveNon ResidentAgentProperty3/22/20211/3/2022 
InactiveNon ResidentAgentCasualty3/22/20211/3/2022 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAAA Life Insurance Company300287Agent - Life9/1/20202/16/2023
ActiveAmeritas Life Insurance Corporation300126Agent - Life9/29/2020 
ActiveAssurity Life Insurance Company301099Agent - Health12/29/2021 
ActiveAssurity Life Insurance Company301099Agent - Life9/26/2017 
ActiveBanner Life Insurance Company301696Agent - Life7/15/2019 
ActiveCMFG Life Insurance Company300929Agent - Life8/4/2020 
InactiveFidelity & Guaranty Life Insurance Company301359Agent - Life3/13/20245/16/2024
ActiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Health6/30/2024 
ActiveJohn Hancock Life Insurance Company (U.S.A.)300132Agent - Life6/30/2024 
ActiveNational Union Fire Insurance Company of Pittsburgh, Pennsylvania300959Agent - Health8/18/2022 
ActivePrincipal National Life Insurance Company301926Agent - Life10/14/2020 
ActiveSenior Life Insurance Company558267Agent - Life1/24/2022 
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveClark, Joshua Edward 1010470Agent - Casualty3/22/20211/3/2022
InactiveClark, Joshua Edward 1010470Agent - Health3/22/20211/3/2022
InactiveClark, Joshua Edward 1010470Agent - Life3/22/20211/3/2022
InactiveClark, Joshua Edward 1010470Agent - Property3/22/20211/3/2022
InactiveColis, Peter George 931524Administrator - Not Applicable5/8/20193/28/2023
InactiveColis, Peter George 931524Agent - Life10/26/20161/3/2022
DeniedCooper, Shane A 1126321Agent - Casualty  
InactiveCooper, Shane A 1126321Agent - Health12/29/202111/8/2022
InactiveCooper, Shane A 1126321Agent - Life1/3/202211/8/2022
DeniedCooper, Shane A 1126321Agent - Property  
ActiveMould, Michael Thomas 644002Administrator - Not Applicable4/25/2023 
ActiveMould, Michael Thomas 644002Agent - Health11/9/2022 
ActiveMould, Michael Thomas 644002Agent - Life11/9/2022 

© Commonwealth of Kentucky. All rights reserved.