Search → STEPHEN DOUGLAS FORMAN
DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE
STEPHEN DOUGLAS FORMAN
PRODUCER NON-RESIDENT
License Number:
PRN99563
Status:
First Licensure:
10/31/2003
Cancel Date:
None
Mailing:
BELLEVUE, WA 98005
Phone:
+1 (425) 462-9500
Fax:
+1 (425) 462-9839
Email:
steve@ltc-associates.com
| License Type | Start Date | End Date |
|---|---|---|
| PRODUCER NON-RESIDENT | 10/31/2003 |
| Name | Issue Date | License Number | Expiration Date | Cancel Date |
|---|---|---|---|---|
| LONG TERM CARE ASSOCIATES INC |
10/31/2003 | AGN99564 |
| Name | Issue Date | License Number | Expiration Date | Cancel Date |
|---|---|---|---|---|
| GENWORTH LIFE INS CO |
01/06/2004 | LHF46264 | 04/19/2010 | |
| GENWORTH LIFE INS CO |
07/26/2014 | LHF46264 | 05/19/2020 | |
| JOHN HANCOCK LIFE INSURANCE COMPANY |
12/08/2003 | LHF264 | 12/31/2009 | |
| JOHN HANCOCK LIFE INSURANCE COMPANY (USA) |
01/01/2010 | LHF210 | 04/12/2012 | |
| JOHN HANCOCK LIFE INSURANCE COMPANY (USA) |
04/05/2012 | LHF210 | 12/01/2015 | |
| MEDAMERICA INSURANCE COMPANY |
02/01/2013 | LHF82113 | 03/02/2016 | |
| METROPOLITAN LIFE INSURANCE COMPANY |
05/12/2005 | LHF380 | 05/26/2011 | |
| MUTUAL OF OMAHA INSURANCE COMPANY |
07/12/2010 | LHF84 | 07/22/2011 | |
| MUTUAL OF OMAHA INSURANCE COMPANY |
09/21/2015 | LHF84 | 01/23/2017 | |
| MUTUAL OF OMAHA INSURANCE COMPANY |
01/21/2018 | LHF84 | 02/22/2019 | |
| NATIONAL GUARDIAN LIFE INSURANCE COMPANY |
02/26/2021 | LHF84860 | ||
| STATE LIFE INSURANCE COMPANY |
04/03/2017 | LHF984 | ||
| UNITED OF OMAHA LIFE INSURANCE COMPANY |
01/27/2012 | LHF28 | 07/22/2013 | |
| UNITED OF OMAHA LIFE INSURANCE COMPANY |
08/09/2013 | LHF28 | 07/22/2014 |
| Description | Issue Date | Termination Date | Status |
|---|---|---|---|
| HEALTH | 10/31/2003 | Active | |
| LIFE | 10/31/2003 | Active |
| Name | License Number |
|---|---|
| LONG TERM CARE ASSOCIATES INC | AGN99564 |
License/Disciplinary Action
None.
GENERAL INFORMATION
NAIC Information
National Producer Number (NPN):
5774650
| Address | Type |
|---|---|
| BELLEVUE, WA 98005 |
Office |
An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.
Date: 11/28/2025 05:30:47 PM
