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 ResidentAgentCasualty3/22/20211/3/2022 
InactiveNon ResidentAgentProperty3/22/20211/3/2022 
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Administrator01/15/202603/31/2026   
Agent01/15/202603/31/2026   
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.