DEPARTMENT OF INSURANCE

Name	Keystone Ins & Benefits Group LLC	DOIID	716920	NAIC NPN	14298459

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Agent	Life	10/30/2009		3/31/2027
Active	Non Resident	Agent	Health	10/30/2009		3/31/2027

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2025	03/31/2025	01/21/2025	01/21/2025	Yes

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

Address Information

Type	Address
Business / Home Office	13800 Jackson Rd Mishawaka, IN 465449195

Internet Information

Type	Address
Business Email	rdeitrick@keystoneinsgrp.com
Internet	www.keystoneinsgrp.com

Phone Information

Type	Phone
Business / Home Office	(574) 231-6500