DEPARTMENT OF INSURANCE

Affiliations

Name	Brigham, Derek J	DOIID	334696	NAIC NPN	251760

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Administrator	Not Applicable	3/26/2003	5/31/2005
Inactive	Non Resident	Agent	Personal Lines	8/13/2003	5/31/2005
Inactive	Non Resident	Agent	Variable Life and Variable Annuities	5/31/2001	5/31/2005
Inactive	Non Resident	Agent	Health	1/25/2018	5/31/2021
Inactive	Non Resident	Agent	General Lines	7/3/1997	8/15/2000
Inactive	Non Resident	Agent	Life	1/25/2018	5/31/2021
Inactive	Non Resident	Agent	Property	8/9/2021	5/31/2023
Inactive	Non Resident	Agent	Casualty	8/9/2021	5/31/2023
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Notice: The Department verifies, at the time of application for a Variable Life and Variable Annuity line of authority, that an agent is registered with the Financial Industry Regulatory Authority (FINRA) and the applicant has passed the Series 6 or greater exam. The Department does not verify registration with FINRA after the agent is qualified by the Department to receive the Variable Life and Variable Annuity line of authority. If you have questions about a broker’s FINRA registration status, you should check this status directly with FINRA.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	4/19/2001	8/15/2005
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	4/19/2001	8/15/2005
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	5/1/2000	11/20/2002
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	5/1/2000	11/20/2002
Inactive	American Heritage Life Insurance Company	300272	Agent - Health	12/1/2003	5/31/2005
Inactive	American Heritage Life Insurance Company	300272	Agent - Life	12/1/2003	5/31/2005
Inactive	American Manufacturers Mutual Insurance Company	301807	Agent - Casualty	2/12/2003	5/31/2003
Inactive	American Manufacturers Mutual Insurance Company	301807	Agent - Property	2/12/2003	5/31/2003
Inactive	American Motorists Insurance Company	301212	Agent - Casualty	2/12/2003	5/31/2003
Inactive	American Motorists Insurance Company	301212	Agent - Property	2/12/2003	5/31/2003
Inactive	American National Insurance Company	301861	Agent - Health	7/2/2003	5/31/2005
Inactive	American National Insurance Company	301861	Agent - Life	7/2/2003	5/31/2005
Inactive	Assurity Life Insurance Company	301099	Agent - Health	8/3/2000	8/16/2005
Inactive	Assurity Life Insurance Company	301099	Agent - Life	8/3/2000	8/16/2005
Inactive	Banner Life Insurance Company	301696	Agent - Life	8/19/2003	5/31/2005
Inactive	CMFG Life Insurance Company	300929	Agent - Health	8/18/2009	7/13/2010
Inactive	CMFG Life Insurance Company	300929	Agent - Life	8/18/2009	7/13/2010
Inactive	CUMIS Insurance Society Inc.	300859	Agent - Casualty	8/15/2000	5/31/2005
Inactive	CUMIS Insurance Society Inc.	300859	Agent - General Lines	7/3/1997	8/15/2000
Inactive	CUMIS Insurance Society Inc.	300859	Agent - Property	8/15/2000	5/31/2005
Inactive	CUNA Mutual Life Insurance Company	301467	Agent - Variable Life and Variable Annuities	5/31/2001	5/31/2005
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Health	11/15/1999	5/31/2005
Inactive	Chase Insurance Life and Annuity Company	300518	Agent - Life	11/15/1999	5/31/2005
Inactive	Clarica Life Insurance Company - U.S.	300207	Agent - Life	3/21/2002	4/26/2004
Inactive	Clear Spring Property and Casualty Company	301377	Agent - Casualty	2/12/2003	5/31/2003
Inactive	Clear Spring Property and Casualty Company	301377	Agent - Property	2/12/2003	5/31/2003
Inactive	Clearcover Insurance Company	1118667	Agent - Casualty	10/7/2021	5/26/2022
Inactive	Clearcover Insurance Company	1118667	Agent - Property	10/7/2021	5/26/2022
Inactive	Delaware Life Insurance Company	301256	Agent - Life	12/31/2003	5/31/2005
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Health	11/15/1999	5/31/2005
Inactive	Fidelity Life Association, A Legal Reserve Life Insurance Company	300774	Agent - Life	11/15/1999	5/31/2005
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Health	8/10/2000	3/13/2003
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	8/10/2000	3/13/2003
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Casualty	10/9/2009	6/8/2011
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Property	10/9/2009	6/8/2011
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Health	4/17/2000	5/31/2005
Inactive	First Penn-Pacific Life Insurance Company	301581	Agent - Life	4/17/2000	5/31/2005
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	12/31/2009	9/8/2010
Inactive	John Hancock Life Insurance Company	300821	Agent - Health	11/13/2000	5/31/2005
Inactive	John Hancock Life Insurance Company	300821	Agent - Life	11/13/2000	5/31/2005
Inactive	John Hancock Variable Life Insurance Company	301914	Agent - Life	11/13/2000	5/31/2005
Inactive	Keyport Life Insurance Company	300319	Agent - Life	3/11/2003	12/31/2003
Inactive	LM General Insurance Company	300133	Agent - Casualty	3/19/2010	6/8/2011
Inactive	LM General Insurance Company	300133	Agent - Property	3/19/2010	6/8/2011
Inactive	LM Insurance Corporation	301061	Agent - Casualty	10/9/2009	6/8/2011
Inactive	LM Insurance Corporation	301061	Agent - Property	10/9/2009	6/8/2011
Inactive	Liberty Insurance Corporation	300444	Agent - Casualty	10/9/2009	6/8/2011
Inactive	Liberty Insurance Corporation	300444	Agent - Property	10/9/2009	6/8/2011
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	10/9/2009	6/8/2011
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Property	10/9/2009	6/8/2011
Inactive	Liberty Mutual Insurance Company	301159	Agent - Casualty	10/9/2009	6/8/2011
Inactive	Liberty Mutual Insurance Company	301159	Agent - Property	10/9/2009	6/8/2011
Inactive	Lincoln Benefit Life Company	301110	Agent - Health	3/24/2000	5/31/2005
Inactive	Lincoln Benefit Life Company	301110	Agent - Life	3/24/2000	5/31/2005
Inactive	Lumbermens Mutual Casualty Company	301119	Agent - Casualty	2/12/2003	5/31/2003
Inactive	Lumbermens Mutual Casualty Company	301119	Agent - Property	2/12/2003	5/31/2003
Inactive	Midland National Life Insurance Company	300923	Agent - Life	4/26/2004	3/9/2005
Inactive	Midvale Indemnity Company	300292	Agent - Casualty	2/12/2003	5/31/2003
Inactive	Midvale Indemnity Company	300292	Agent - Property	2/12/2003	5/31/2003
Inactive	Mutual Trust Life Insurance Company, A Pan-American Life Insurance Group Stock Company	300585	Agent - Health	10/23/2000	1/19/2005
Inactive	Mutual Trust Life Insurance Company, A Pan-American Life Insurance Group Stock Company	300585	Agent - Life	10/23/2000	1/19/2005
Inactive	Mutual of Omaha Insurance Company	301012	Agent - Health	10/8/1999	5/31/2005
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Health	2/14/2001	10/26/2002
Inactive	Penn Treaty Network America Insurance Company	301297	Agent - Life	2/14/2001	10/26/2002
Inactive	Philadelphia Indemnity Insurance Company	301221	Agent - Casualty	7/25/2002	8/19/2005
Inactive	Philadelphia Indemnity Insurance Company	301221	Agent - Property	7/25/2002	8/19/2005
Inactive	Principal Life Insurance Company	300129	Agent - Health	9/4/2003	5/31/2005
Inactive	Principal Life Insurance Company	300129	Agent - Life	9/4/2003	5/31/2005
Inactive	Pruco Life Insurance Company	300954	Agent - Health	10/6/2000	5/31/2005
Inactive	Pruco Life Insurance Company	300954	Agent - Life	10/6/2000	5/31/2005
Inactive	Prudential Insurance Company of America	300784	Agent - Health	10/6/2000	5/31/2005
Inactive	Prudential Insurance Company of America	300784	Agent - Life	10/6/2000	5/31/2005
Inactive	ReliaStar Life Insurance Company	301712	Agent - Health	10/1/2003	7/18/2005
Inactive	ReliaStar Life Insurance Company	301712	Agent - Life	10/1/2003	7/18/2005
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Health	1/7/2000	10/1/2003
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Life	1/7/2000	10/1/2003
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Health	6/4/2004	5/31/2005
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Life	6/4/2004	5/31/2005
Inactive	Talcott Resolution Life Insurance Company	301759	Agent - Variable Life and Variable Annuities	6/4/2004	5/31/2005
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	6/4/2004	5/31/2005
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	6/4/2004	5/31/2005
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Variable Life and Variable Annuities	6/4/2004	5/31/2005
Inactive	Transamerica Life Insurance Company	300571	Agent - Life	6/30/2000	5/31/2005
Inactive	USG Annuity & Life Company	300457	Agent - Health	2/18/2000	1/1/2004
Inactive	USG Annuity & Life Company	300457	Agent - Life	2/18/2000	1/1/2004
Inactive	Union Central Life Insurance Company	300307	Agent - Health	9/18/2003	5/31/2005
Inactive	Union Central Life Insurance Company	300307	Agent - Life	9/18/2003	5/31/2005
Inactive	United of Omaha Life Insurance Company	300156	Agent - Health	2/18/2000	5/31/2005
Inactive	United of Omaha Life Insurance Company	300156	Agent - Life	2/18/2000	5/31/2005
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Health	5/14/2001	5/31/2005
Inactive	UnitedHealthcare Insurance Company	300946	Agent - Life	5/14/2001	5/31/2005
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Health	1/1/2004	5/31/2005
Inactive	Venerable Insurance and Annuity Company	301006	Agent - Life	1/1/2004	5/31/2005
Inactive	Virginia Surety Company, Inc.	301022	Agent - Casualty	12/18/2000	5/31/2005
Inactive	Virginia Surety Company, Inc.	301022	Agent - Property	12/18/2000	5/31/2005
Inactive	West Coast Life Insurance Company	301607	Agent - Life	4/10/2000	5/31/2005
Inactive		300277	Agent - Health	3/13/2000	5/31/2005
Inactive		300277	Agent - Life	3/13/2000	5/31/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CUNA Mutual Insurance Agency, Inc	573668	Agent - Life	10/22/2009	7/13/2010
Inactive	CUNA Mutual Insurance Agency, Inc	573668	Agent - Health	10/22/2009	7/26/2010
Inactive	CUNA Mutual Insurance Agency, Inc	573668	Agent - Variable Life and Variable Annuities	7/28/2003	5/31/2005
Inactive	CUNA Mutual Insurance Agency, Inc	573668	Agent - Property	10/22/2009	7/26/2010
Inactive	CUNA Mutual Insurance Agency, Inc	573668	Agent - Casualty	10/22/2009	7/26/2010
Denied	CUNA Mutual Insurance Agency, Inc	573668	Agent - Personal Lines
Inactive	Clearcover Ins Agency LLC	1128685	Agent - Life	4/9/2021	5/31/2021
Inactive	Clearcover Ins Agency LLC	1128685	Agent - Property	4/9/2021	5/31/2021
Inactive	Clearcover Ins Agency LLC	1128685	Agent - Casualty	4/9/2021	5/31/2021
Inactive	Cuna Mutual Insurance Agency of Kentucky Inc.	400473	Agent - Life	7/24/1997	3/12/2004
Inactive	Cuna Mutual Insurance Agency of Kentucky Inc.	400473	Agent - Health	7/24/1997	3/15/2004
Inactive	Cuna Mutual Insurance Agency of Kentucky Inc.	400473	Agent - Variable Life and Variable Annuities	5/10/2001	3/12/2004
Inactive	League Insurance Agency, Inc.	565502	Agent - Life	3/10/2003	5/31/2005
Inactive	League Insurance Agency, Inc.	565502	Agent - Health	3/10/2003	5/31/2005
Inactive	League Insurance Agency, Inc.	565502	Administrator - Not Applicable	3/26/2003	5/31/2005