DEPARTMENT OF INSURANCE
Affiliations
NameCommonwealth Administrators, LLC
DBA : Fiserv Health-Commonwealth Administrators		DOIID397899NAIC NPN4402548
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
InactiveResidentAdministratorNot Applicable9/2/19993/19/2015 
InactiveResidentAgentLife12/31/19995/14/2015 
InactiveResidentAgentHealth12/31/19995/14/2015 
* 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
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveACE American Insurance Company300625Agent - Health4/10/20032/26/2007
InactiveAmerican General Life Insurance Company301585Agent - Health12/31/20125/14/2015
InactiveAmerican General Life Insurance Company301585Agent - Life12/31/20125/14/2015
InactiveAmerican General Life Insurance Company of Delaware301057Agent - Health6/4/200112/31/2012
InactiveAmerican General Life Insurance Company of Delaware301057Agent - Life6/4/200112/31/2012
InactiveAmerican Guarantee and Liability Insurance Company301216Agent - Health11/14/20065/14/2015
InactiveAmerican United Life Insurance Company300498Agent - Health6/8/20045/14/2015
InactiveAmerican United Life Insurance Company300498Agent - Life6/8/20045/14/2015
InactiveAmerican Zurich Insurance Company300592Agent - Health11/14/20065/14/2015
InactiveAvemco Insurance Company300669Agent - Health5/29/20012/28/2006
InactiveBaltimore Life Insurance Company300286Agent - Health10/30/200211/18/2004
InactiveBaltimore Life Insurance Company300286Agent - Life10/30/200211/18/2004
InactiveCanada Life Reinsurance Company301491Agent - Health8/15/20001/15/2002
InactiveDelaware Life Insurance Company301256Agent - Life12/31/200312/14/2012
InactiveFort Wayne Health & Casualty Insurance Company301572Agent - Health2/8/200012/22/2004
InactiveHCC Life Insurance Company301827Agent - Health2/28/20069/11/2007
InactiveHCC Life Insurance Company301827Agent - Life2/28/20069/11/2007
InactiveHartford Life Group Insurance Company301708Agent - Health12/21/200512/31/2006
InactiveHartford Life Group Insurance Company301708Agent - Life12/21/200512/31/2006
InactiveHartford Life and Accident Insurance Company300878Agent - Health12/5/20055/14/2015
InactiveHartford Life and Accident Insurance Company300878Agent - Life12/5/20055/14/2015
InactiveKeyport Life Insurance Company300319Agent - Life12/15/200012/31/2003
InactiveLafayette Life Insurance Company (The)301039Agent - Health5/19/20041/23/2008
InactiveLafayette Life Insurance Company (The)301039Agent - Life5/19/20041/23/2008
InactiveLegion Insurance Company301490Agent - Health1/22/20027/1/2003
InactiveLincoln National Life Insurance Company (The)301382Agent - Health2/8/20003/12/2002
InactiveLincoln National Life Insurance Company (The)301382Agent - Life2/8/20003/8/2002
InactiveLincoln National Reassurance Company301919Agent - Health2/8/20001/6/2003
InactiveLincoln National Reassurance Company301919Agent - Life2/8/20001/6/2003
InactivePacific Life & Annuity Company300443Agent - Health6/19/20015/4/2006
InactivePacific Life & Annuity Company300443Agent - Life6/19/20015/4/2006
InactivePacific Life Insurance Company301848Agent - Health6/19/20015/14/2015
InactivePacific Life Insurance Company301848Agent - Life6/19/20015/14/2015
InactiveSwiss Re Life & Health America, Inc.300722Agent - Health1/6/200312/22/2004
InactiveSwiss Re Life & Health America, Inc.300722Agent - Life1/6/200312/22/2004
InactiveSymetra Life Insurance Company301691Agent - Health10/30/20025/14/2015
InactiveSymetra Life Insurance Company301691Agent - Life10/30/20025/14/2015
InactiveTIG Insurance Company301750Agent - Health2/5/200112/11/2001
InactiveUnion Labor Life Insurance Company301832Agent - Health2/16/20017/15/2008
InactiveUnion Labor Life Insurance Company301832Agent - Life2/16/20017/15/2008
InactiveUnion Security Insurance Company301844Agent - Health12/31/19993/1/2004
InactiveUnion Security Insurance Company301844Agent - Life12/31/19993/1/2004
InactiveZurich American Insurance Company301121Agent - Health11/14/20065/14/2015
InactiveZurich American Insurance Company of Illinois301805Agent - Health11/14/20065/14/2015
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveAldridge, Stephanie Renee 525523Agent - Health1/5/20043/1/2015
InactiveAldridge, Stephanie Renee 525523Agent - Life1/5/20043/1/2015
InactiveBlackburn, Douglas Dwayne 350372Administrator - Not Applicable9/2/199910/31/2018
InactiveBlackburn, Douglas Dwayne 350372Agent - Health12/31/19995/14/2015
InactiveBlackburn, Douglas Dwayne 350372Agent - Life12/31/19995/14/2015
InactiveBraun, Helmut Manfred 328248Administrator - Not Applicable12/12/20033/19/2015
InactiveBraun, Helmut Manfred 328248Agent - Health1/22/20075/14/2015
InactiveBraun, Helmut Manfred 328248Agent - Life1/22/20075/14/2015
InactiveBrown, William Robert 393141Administrator - Not Applicable9/2/19993/31/2008
InactiveCox, Charles Clifford 364672Administrator - Not Applicable9/2/19996/30/2014
InactiveCox, Charles Clifford 364672Agent - Health12/31/19992/2/2004
InactiveCox, Charles Clifford 364672Agent - Life12/31/19992/2/2004
InactiveDay, Karen M 327656Administrator - Not Applicable2/14/200112/6/2005
InactiveDay, Karen M 327656Agent - Health12/31/199912/19/2003
InactiveDay, Karen M 327656Agent - Life12/31/199912/19/2003
InactiveDickey, Melissa F 352554Administrator - Not Applicable9/2/19993/7/2008
InactiveDickey, Melissa F 352554Agent - Health12/31/19991/29/2007
InactiveDickey, Melissa F 352554Agent - Life12/31/19991/29/2007
InactiveFilson, Barbara B 386575Administrator - Not Applicable9/2/19993/19/2015
InactiveFilson, Barbara B 386575Agent - Health12/31/19995/14/2015
InactiveFilson, Barbara B 386575Agent - Life12/31/19995/14/2015
InactiveHolton, William O 521096Agent - Health3/9/20073/20/2012
InactiveMcCabe, Jennifer Lynne 613987Agent - Health3/8/200710/1/2007
InactiveMcCabe, Jennifer Lynne 613987Agent - Life3/8/200710/1/2007
InactiveParish, Stephanie Jo 631696Agent - Health1/29/20075/14/2015
InactiveParish, Stephanie Jo 631696Agent - Life1/29/20075/14/2015
InactivePfeifle, Karin Marie 633843Agent - Health1/26/20072/1/2008
InactivePfeifle, Karin Marie 633843Agent - Life1/26/20072/1/2008
InactiveSanger, Matthew Emerson 582796Agent - Health2/1/20056/30/2014
InactiveSanger, Matthew Emerson 582796Agent - Life2/1/20056/30/2014
InactiveStrong, Kimberly Anne 319329Administrator - Not Applicable9/2/19991/31/2010
InactiveStrong, Kimberly Anne 319329Agent - Health3/9/20071/31/2010
InactiveStrong, Kimberly Anne 319329Agent - Life3/9/20071/31/2010
InactiveStump, Richard Elwood 386001Administrator - Not Applicable9/2/199912/31/2011
InactiveStump, Richard Elwood 386001Agent - Health12/31/19991/18/2005
InactiveStump, Richard Elwood 386001Agent - Life12/31/19991/18/2005
InactiveWalker, Carol Sue 615963Agent - Health3/8/20071/12/2015
InactiveWalker, Carol Sue 615963Agent - Life3/8/20071/12/2015
InactiveWardlaw, Tammy Lou 353581Agent - Health2/13/20031/5/2004
InactiveWardlaw, Tammy Lou 353581Agent - Life2/13/20031/4/2004

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