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DEPARTMENT OF INSURANCE
Affiliations
Name
Fidelity Employer Ins Services Inc
DOIID
653192
NAIC NPN
8210273
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Non Resident
Agent
Life
4/1/2009
9/23/2019
Inactive
Non Resident
Agent
Health
4/1/2009
9/23/2019
* If a status Is
Pending, Pending Replacement
,Or the record displays
Affidavit On File
, click On them For more details.
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Beasley, Andrew
869122
Agent - Health
4/3/2015
2/10/2016
Inactive
Beasley, Andrew
869122
Agent - Life
4/3/2015
2/10/2016
Inactive
Brown, Brian J
703613
Agent - Health
11/9/2009
3/21/2011
Inactive
Brown, Brian J
703613
Agent - Life
11/9/2009
3/21/2011
Inactive
Casey, Jason W
655847
Agent - Health
11/11/2009
9/3/2010
Inactive
Casey, Jason W
655847
Agent - Life
11/11/2009
9/3/2010
Inactive
Gustafson, Gary D
650803
Agent - Health
10/6/2009
10/2/2012
Inactive
Gustafson, Gary D
650803
Agent - Life
10/6/2009
10/2/2012
Inactive
Hancock, Joni Marie
712765
Agent - Health
11/11/2009
1/5/2011
Inactive
Hancock, Joni Marie
712765
Agent - Life
11/11/2009
1/5/2011
Inactive
Hannan, Cynthia
807741
Agent - Health
2/20/2014
2/8/2018
Inactive
Hannan, Cynthia
807741
Agent - Life
2/20/2014
2/8/2018
Inactive
Harty, Brian
651313
Agent - Health
11/11/2009
7/31/2013
Inactive
Harty, Brian
651313
Agent - Life
11/11/2009
7/31/2013
Inactive
Joss, Jonathan Edward
706177
Agent - Health
10/6/2009
1/31/2017
Inactive
Joss, Jonathan Edward
706177
Agent - Life
10/6/2009
1/31/2017
Inactive
Kennedy, Robert H
809403
Agent - Health
2/20/2014
9/23/2019
Inactive
Kennedy, Robert H
809403
Agent - Life
2/20/2014
9/23/2019
Inactive
Kimler, Bradford James
650105
Agent - Health
4/1/2009
6/17/2016
Inactive
Kimler, Bradford James
650105
Agent - Life
4/1/2009
6/17/2016
Inactive
Krinsky, Ross Mark
786200
Agent - Health
2/20/2014
9/23/2019
Inactive
Krinsky, Ross Mark
786200
Agent - Life
2/20/2014
9/23/2019
Inactive
Machera, Rachel R
660553
Agent - Health
11/11/2009
9/23/2019
Inactive
Machera, Rachel R
660553
Agent - Life
11/11/2009
9/23/2019
Inactive
Martinek, Eric N
702208
Agent - Health
10/6/2009
1/5/2010
Inactive
Martinek, Eric N
702208
Agent - Life
10/6/2009
1/5/2010
Inactive
Neville, Laura J
650276
Agent - Health
11/11/2009
3/19/2013
Inactive
Neville, Laura J
650276
Agent - Life
11/11/2009
3/19/2013
Inactive
Patel, Sunit R
649182
Agent - Health
10/6/2009
4/24/2017
Inactive
Patel, Sunit R
649182
Agent - Life
10/6/2009
4/24/2017
Inactive
Stavisky, Adam Gordon
657989
Agent - Health
11/11/2009
2/28/2018
Inactive
Stavisky, Adam Gordon
657989
Agent - Life
11/11/2009
2/28/2018
Inactive
Weaver, Pearce R
707853
Agent - Health
11/11/2009
9/23/2019
Inactive
Weaver, Pearce R
707853
Agent - Life
11/11/2009
9/23/2019
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