Details for SELPH, ETHAN WAYNE
| License | Status | Expires | Number |
|---|---|---|---|
| Non-Resident Producer | Active | Aug 31, 2022 | 583045 |
| Accident and Hlth or Sickness | Active | Issued: Aug 09, 2018 | |
| Life | Active | Issued: Aug 16, 2016 | |
| Accident & Health | Inactive | Issued: Aug 16, 2016 | |
| Resident Producer | Inactive | Aug 16, 2016 | 234659 |
| Accident & Health | Inactive | Issued: Nov 23, 2005 | |
| Life | Inactive | Issued: Nov 23, 2005 |
| Agency Affiliations | City | State | License Number | Active Date | Status |
|---|---|---|---|---|---|
| HEALTH PLAN INTERMEDIARIES HOLDINGS LLC | TAMPA | FL | 514705 | Apr 10, 2018 | Active |
| HEALTH PLAN INTERMEDIARIES HOLDINGS LLC | TAMPA | FL | 418652 | Apr 10, 2018 | Active |
| Company Affiliations | City | State | Type | Active Date |
|---|---|---|---|---|
| AMERICAN GENERAL LIFE INSURANCE COMPANY | MILWAUKEE | WI | Life | Oct 21, 2016 |
| AMERICAN GENERAL LIFE INSURANCE COMPANY | MILWAUKEE | WI | Accident and Hlth or Sickness | Aug 09, 2018 |
| CIGNA HEALTH AND LIFE INSURANCE COMPANY | PHILADELPHIA | PA | Life, Accident and Hlth or Sickness | Nov 27, 2019 |
| INDEPENDENCE AMERICAN INSURANCE COMPANY (AIC) | NEW YORK | NY | Accident and Hlth or Sickness | Aug 09, 2018 |
| SelectHealth Inc | MURRAY | UT | Accident and Hlth or Sickness | Aug 09, 2018 |