DEPARTMENT OF INSURANCE

Name	1 Sourceadmin LLC DBA : Connected Benefits	DOIID	853638	NAIC NPN	17168811

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	9/25/2014	3/31/2018
Inactive	Non Resident	Agent	Health	9/25/2014	3/31/2018

*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	12050 Rosemount Drive Fort Myers, FL 33901

Phone Information

Type	Phone
Business / Home Office	(802) 497-2846