DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Selph, Ethan Wayne	DOIID	936494	NAIC NPN	8682220

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	9/13/2023		8/31/2025
Active	Non Resident	Agent	Life	9/13/2023		8/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	06/15/2025	08/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Health	1/26/2017	8/31/2021
Inactive	American Financial Security Life Insurance Co.	301635	Agent - Life	1/26/2017	8/31/2021
Inactive	American General Life Insurance Company	301585	Agent - Health	12/6/2016	12/23/2019
Inactive	American General Life Insurance Company	301585	Agent - Life	12/6/2016	12/23/2019
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	9/17/2023
Inactive	Anthem Life Insurance Company	301209	Agent - Health	9/17/2023	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	9/17/2023	4/15/2025
Active	CareSource Kentucky Co.	838179	Agent - Health	1/5/2024
Inactive	Federal Insurance Company	301144	Agent - Health	10/13/2017	8/31/2021
Active	Golden Rule Insurance Company	301943	Agent - Health	10/27/2023
Active	Golden Rule Insurance Company	301943	Agent - Life	10/27/2023
Inactive	Independence American Insurance Company	524747	Agent - Health	4/27/2017	12/11/2019
Inactive	LifeShield National Insurance Company	737111	Agent - Health	12/14/2018	8/31/2021
Inactive	Lumico Life Insurance Company	300354	Agent - Life	10/27/2023	12/3/2024
Active	Molina Healthcare of Kentucky, Inc.	1035856	Agent - Health	9/21/2023
Inactive	Standard Life and Accident Insurance Company	301534	Agent - Health	4/5/2017	8/31/2021
Inactive	Unified Life Insurance Company	543169	Agent - Health	12/22/2016	12/12/2017
Active	WellCare Health Plans of Kentucky, Inc.	838592	Agent - Health	2/21/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Designated Agent Company Inc.	681257	Agent - Life	1/16/2019	5/11/2021
Inactive	Designated Agent Company Inc.	681257	Agent - Health	1/16/2019	5/11/2021
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Life	4/13/2018	8/31/2021
Inactive	Health Plan Intermediaries Holdings	786463	Agent - Health	4/13/2018	8/31/2021