DEPARTMENT OF INSURANCE

Affiliations

Name	Ethos Technologies Inc. DBA : ETHOS LIFE INSURANCE SERVICES	DOIID	934675	NAIC NPN	18166550

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	5/8/2019		3/31/2028
Active	Non Resident	Agent	Health	3/22/2021		3/31/2028
Active	Non Resident	Agent	Life	10/26/2016		3/31/2028
Inactive	Non Resident	Agent	Property	3/22/2021	1/3/2022
Inactive	Non Resident	Agent	Casualty	3/22/2021	1/3/2022
* 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

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AAA Life Insurance Company	300287	Agent - Life	9/1/2020	2/16/2023
Active	Ameritas Life Insurance Corporation	300126	Agent - Life	1/5/2026
Active	Assurity Life Insurance Company	301099	Agent - Health	12/29/2021
Active	Assurity Life Insurance Company	301099	Agent - Life	9/26/2017
Active	Banner Life Insurance Company	301696	Agent - Life	7/15/2019
Active	CMFG Life Insurance Company	300929	Agent - Life	8/4/2020
Active	Fidelity & Guaranty Life Insurance Company	301359	Agent - Life	2/9/2026
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Health	6/30/2024
Active	John Hancock Life Insurance Company (U.S.A.)	300132	Agent - Life	6/30/2024
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	8/18/2022
Active	North American Company for Life and Health Insurance	300291	Agent - Life	8/31/2025
Active	Principal National Life Insurance Company	301926	Agent - Life	10/14/2020
Active	Senior Life Insurance Company	558267	Agent - Life	1/24/2022
Active	Tier One Insurance Company	301056	Agent - Health	7/31/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending	Abbe, Ethan	1039048	Agent - Health
Active	Abbe, Ethan	1039048	Agent - Life	2/10/2026
Pending	Axberg, Brian J	1106170	Agent - Health
Active	Axberg, Brian J	1106170	Agent - Life	2/10/2026
Active	Bastyr, Ryne	992633	Agent - Health	2/10/2026
Active	Bastyr, Ryne	992633	Agent - Life	2/10/2026
Pending	Batchelor, Kaleb	748574	Agent - Health
Pending	Batchelor, Kaleb	748574	Agent - Life
Pending	Black, Kris A	762036	Agent - Health
Pending	Black, Kris A	762036	Agent - Life
Active	Brea, Daylin	901531	Agent - Health	2/10/2026
Active	Brea, Daylin	901531	Agent - Life	2/10/2026
Active	Carter, Jamaal	736251	Agent - Health	2/10/2026
Active	Carter, Jamaal	736251	Agent - Life	2/10/2026
Active	Chavez, Michael Andrew	985549	Agent - Health	2/10/2026
Active	Chavez, Michael Andrew	985549	Agent - Life	2/10/2026
Inactive	Clark, Joshua Edward	1010470	Agent - Casualty	3/22/2021	1/3/2022
Inactive	Clark, Joshua Edward	1010470	Agent - Health	3/22/2021	1/3/2022
Inactive	Clark, Joshua Edward	1010470	Agent - Life	3/22/2021	1/3/2022
Inactive	Clark, Joshua Edward	1010470	Agent - Property	3/22/2021	1/3/2022
Inactive	Colis, Peter George	931524	Administrator - Not Applicable	5/8/2019	3/28/2023
Inactive	Colis, Peter George	931524	Agent - Life	10/26/2016	1/3/2022
Denied	Cooper, Shane A	1126321	Agent - Casualty
Inactive	Cooper, Shane A	1126321	Agent - Health	12/29/2021	11/8/2022
Inactive	Cooper, Shane A	1126321	Agent - Life	1/3/2022	11/8/2022
Denied	Cooper, Shane A	1126321	Agent - Property
Pending	Coulter, John	1322886	Agent - Health
Active	Coulter, John	1322886	Agent - Life	2/10/2026
Pending	Davis, Phillip	710372	Agent - Health
Inactive	Davis, Phillip	710372	Agent - Life	2/10/2026	2/12/2026
Active	Dietschy, Steven Joesph	700751	Agent - Health	2/10/2026
Active	Dietschy, Steven Joesph	700751	Agent - Life	2/10/2026
Active	Dobbins, Jacob C	1185528	Agent - Health	2/9/2026
Active	Dobbins, Jacob C	1185528	Agent - Life	12/28/2025
Pending	Dorsey, Seriozha Simone	905961	Agent - Health
Inactive	Dorsey, Seriozha Simone	905961	Agent - Life	2/10/2026	5/28/2026
Active	Duggan, John Patrick	1073936	Agent - Health	2/10/2026
Active	Duggan, John Patrick	1073936	Agent - Life	2/10/2026
Pending	Evans, Keisha	1160738	Agent - Health
Pending	Evans, Keisha	1160738	Agent - Life
Pending	Ewing, Baeleit	381262	Agent - Health
Active	Ewing, Baeleit	381262	Agent - Life	4/7/2026
Pending	Ferranti, Sarai Margarite	841543	Agent - Health
Active	Ferranti, Sarai Margarite	841543	Agent - Life	2/10/2026
Pending	Forbes, Preston	1335913	Agent - Health
Pending	Forbes, Preston	1335913	Agent - Life
Pending	Fulkerson, Michael Gene	900613	Agent - Health
Pending	Fulkerson, Michael Gene	900613	Agent - Life
Pending	Graf, Eric G	805360	Agent - Health
Pending	Graf, Eric G	805360	Agent - Life
Active	Hedges, Dustin Michael	931405	Agent - Health	2/10/2026
Active	Hedges, Dustin Michael	931405	Agent - Life	2/10/2026
Active	Hedges, Matthew Brandon	931825	Agent - Health	2/10/2026
Pending	Hedges, Matthew Brandon	931825	Agent - Life
Pending	Heilman, Damon	1121146	Agent - Health
Active	Heilman, Damon	1121146	Agent - Life	2/10/2026
Pending	Hudnall, Barry Joseph	895011	Agent - Health
Pending	Hudnall, Barry Joseph	895011	Agent - Life
Pending	Iboa, Jonathan	1152079	Agent - Health
Active	Iboa, Jonathan	1152079	Agent - Life	2/10/2026
Inactive	Jones, Peter P	995954	Agent - Health	2/10/2026	3/25/2026
Inactive	Jones, Peter P	995954	Agent - Life	2/10/2026	3/25/2026
Active	Kennedy, Michael Douglas	1016163	Agent - Health	2/10/2026
Active	Kennedy, Michael Douglas	1016163	Agent - Life	2/10/2026
Active	Kerby, Lisa Ann	639765	Agent - Health	2/10/2026
Active	Kerby, Lisa Ann	639765	Agent - Life	2/10/2026
Pending	Lomeli, Rafael Alfredo	969568	Agent - Health
Pending	Lomeli, Rafael Alfredo	969568	Agent - Life
Active	Lopez, Laura Aniz	730290	Agent - Health	2/10/2026
Active	Lopez, Laura Aniz	730290	Agent - Life	2/10/2026
Pending	Mallen, Isabella	1442284	Agent - Health
Active	Mallen, Isabella	1442284	Agent - Life	5/20/2026
Pending	Mancilla, Jorge Ivan	1002762	Agent - Health
Active	Mancilla, Jorge Ivan	1002762	Agent - Life	5/14/2026
Pending	Mansell, Ross William	750228	Agent - Health
Pending	Mansell, Ross William	750228	Agent - Life
Active	Marshall, Joanne Mical	1399792	Agent - Life	2/10/2026
Pending	Mcgee, Ryan L	728743	Agent - Health
Active	Mcgee, Ryan L	728743	Agent - Life	2/6/2026
Pending	Merchent, Patrick M	992356	Agent - Health
Inactive	Merchent, Patrick M	992356	Agent - Life	3/17/2026	3/19/2026
Pending	Montero, Adrian Michael	763790	Agent - Health
Active	Montero, Adrian Michael	763790	Agent - Life	2/26/2026
Pending	Montgomery, Eric Kyle	873756	Agent - Health
Pending	Montgomery, Eric Kyle	873756	Agent - Life
Pending	Mosson, Tanner L	1165797	Agent - Health
Pending	Mosson, Tanner L	1165797	Agent - Life
Active	Mould, Michael Thomas	644002	Administrator - Not Applicable	4/25/2023
Active	Mould, Michael Thomas	644002	Agent - Health	11/9/2022
Active	Mould, Michael Thomas	644002	Agent - Life	11/9/2022
Active	Muhs, Marc	801173	Agent - Health	2/10/2026
Active	Muhs, Marc	801173	Agent - Life	2/10/2026
Active	Murray, Terri D	831611	Agent - Health	2/10/2026
Active	Murray, Terri D	831611	Agent - Life	2/10/2026
Active	Ogle, Steven Michael	739051	Agent - Health	2/10/2026
Active	Ogle, Steven Michael	739051	Agent - Life	2/10/2026
Pending	Padgett, Nicholas A	831036	Agent - Health
Active	Padgett, Nicholas A	831036	Agent - Life	2/10/2026
Active	Perillo, Nicholas	1042319	Agent - Health	2/10/2026
Active	Perillo, Nicholas	1042319	Agent - Life	2/10/2026
Active	Pierce, Scott Evan	1153960	Agent - Health	2/10/2026
Active	Pierce, Scott Evan	1153960	Agent - Life	2/10/2026
Active	Pineda, Thomas	1155000	Agent - Health	2/10/2026
Active	Pineda, Thomas	1155000	Agent - Life	2/10/2026
Pending	Reich, Shane Eric	1067268	Agent - Health
Pending	Reich, Shane Eric	1067268	Agent - Life
Pending	Reiss, Evan T	1415457	Agent - Health
Pending	Reiss, Evan T	1415457	Agent - Life
Pending	Rivera Sanchez, Jonathan Stiven	1057723	Agent - Health
Pending	Rivera Sanchez, Jonathan Stiven	1057723	Agent - Life
Active	Rojas, Seth	1028653	Agent - Health	2/10/2026
Active	Rojas, Seth	1028653	Agent - Life	2/10/2026
Active	Sanchez, Gabriel Omar	1103400	Agent - Health	2/10/2026
Pending	Sanchez, Gabriel Omar	1103400	Agent - Life
Active	Schadegg, Michael Carl	894185	Agent - Health	2/10/2026
Active	Schadegg, Michael Carl	894185	Agent - Life	2/10/2026
Active	Searcy, Shani Olisa	1437922	Agent - Health	2/10/2026
Pending	Searcy, Shani Olisa	1437922	Agent - Life
Pending	Shapiro, Benjamin Ernest	969226	Agent - Health
Pending	Shapiro, Benjamin Ernest	969226	Agent - Life
Pending	Sledge, Brian A	1379700	Agent - Health
Pending	Sledge, Brian A	1379700	Agent - Life
Active	Tellup, Rebecca Michelle	999037	Agent - Health	2/10/2026
Active	Tellup, Rebecca Michelle	999037	Agent - Life	4/30/2026
Inactive	Teweles, Josh A	851160	Agent - Health	2/10/2026	3/24/2026
Inactive	Teweles, Josh A	851160	Agent - Life	2/10/2026	3/24/2026
Pending	Truitt, Justin	1335401	Agent - Health
Pending	Truitt, Justin	1335401	Agent - Life
Pending	Veit, Colleen	1402090	Agent - Health
Active	Veit, Colleen	1402090	Agent - Life	2/10/2026
Pending	Vooris, Adam	1008607	Agent - Health
Pending	Vooris, Adam	1008607	Agent - Life
Active	Wang, Lingke	931525	Agent - Health	2/10/2026
Active	Wang, Lingke	931525	Agent - Life	2/10/2026
Active	Watson, Joshua	955673	Agent - Health	2/10/2026
Active	Watson, Joshua	955673	Agent - Life	2/10/2026
Active	Williams-Howard, Kimberly	1158707	Agent - Health	2/10/2026
Pending	Williams-Howard, Kimberly	1158707	Agent - Life
Active	Woodruff, Michael Joe	830976	Agent - Health	2/10/2026
Active	Woodruff, Michael Joe	830976	Agent - Life	2/10/2026
Inactive	Youel, Esho	1442475	Agent - Health	2/10/2026	4/16/2026
Active	Youel, Esho	1442475	Agent - Life	2/10/2026
Inactive	Zich, Matthew Thomas	892659	Agent - Health	2/10/2026	2/26/2026
Active	Zich, Matthew Thomas	892659	Agent - Life	2/10/2026