DEPARTMENT OF INSURANCE
Insurer Details
NAMEModern Woodmen of America
DOI ID301213
FEIN #361493430
ALIEN #
State of DomicileIL
Domicile Country
Merged Into
NAIC #57541
NAIC Group #
Entity TypeInsurer
Admitted8/3/1916
AM Best Rating
PresidentJerald James Lyphout
Process AgentAttn: Legal Department
Date Assigned : 4/24/2009
(See address table below for process agent address)

Authorized Insurer – these insurers are authorized to do the business of insurance by holding a Kentucky Certificate of Authority. Provides insurance coverage.
Line(s) of Authority
Fraternal Benefit Society
Life
Health
TypeAddress
Agent Licensing Address1701 1st Ave Rock Island, IL 61201
Annual Statement1701 FIRST AVENUE ROCK ISLAND, IL 612018779
Catastrophe/Disaster Coordinator Address1701 1st Ave. Rock Island, IL 61201
Consumer Complaint1701 1st Ave. Rock Island, IL 61201
Continuing Education Provider 1701 - 1st Avenue Rock Island, IL 61201
Mailing1701 First Avenue Rock Island, IL 612018779
P & C Form and Rate Filing1701 1st Ave. Rock Island, IL 61201
Policyholder Information Contact Address1701 1st Ave. Rock Island, IL 61201
Process Agent1701 1st Avenue Rock Island, IL 61201
Reinsurance Carrier Address1701 1st Ave. Rock Island, IL 61201
Statutory Home Office1701 First Avenue Rock Island, IL 612018779
TypeNumber
Consumer Complaint - Business / Home Office(309) 793-5551
Catastrophe/Disaster Coordination Contact - Business / Home Office(309) 793-5551
P & C Form and Rate Filing - Business / Home Office(309) 793-5551
Policyholder Information Contact - Business / Home Office(309) 793-5551
Regulatory Compliance/Gvmt Relations Contact - Business / Home Office(309) 793-5551
Business / Home Office(309) 786-6481
Annual Statement - Fax(309) 793-5688
Consumer Complaint - Fax(309) 793-5508
Catastrophe/Disaster Coordination Contact - Fax(309) 793-5508
P & C Form and Rate Filing - Fax(309) 793-5508
Policyholder Information Contact - Fax(309) 793-5508
Regulatory Compliance/Gvmt Relations Contact - Fax(309) 793-5508
CE/PL Provider(309) 786-6481 - 5581
Licensing - Agent Licensing Phone(800) 447-9811
Annual Statement - Annual Statement(309) 793-5537
TypeInternet Information
Annual Statement - Business Emailjeffrey.bach@modern-woodmen.org
Business Emailalex.backes@modern-woodmen.org
Regulatory Compliance/Gvmt Relations Contact - Business EmailComplianceDepartment@modern-woodmen.org
Consumer Complaint - Business EmailComplianceDepartment@modern-woodmen.org
Catastrophe/Disaster Coordination Contact - Business EmailComplianceDepartment@modern-woodmen.org
P & C Form and Rate Filing - Business EmailComplianceDepartment@modern-woodmen.org
Policyholder Information Contact - Business EmailComplianceDepartment@modern-woodmen.org

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