DEPARTMENT OF INSURANCE

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	Designated Home State
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.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	One Spartan Way Mailzone Mm1gMerrimack, NH 03054

Internet Information

Type	Address
Business Email	FIDELITY@LICENSE-SUPPORT.COM

Phone Information

Type	Phone
Business / Home Office	(617) 563-7624