DEPARTMENT OF INSURANCE

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.

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
Active	Anthem Life Insurance Company	301209	Agent - Health	9/17/2023
Active	Anthem Life Insurance Company	301209	Agent - Life	9/17/2023
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
Active	Lumico Life Insurance Company	300354	Agent - Life	10/27/2023
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