black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

INSURANCE PLACEMENT SERVICES INC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN79655
Status:
First Licensure:
07/20/2001
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
1 STATE FARM PLZ # C-3
BLOOMINGTON, IL 61710-0001
Mailing:
1 STATE FARM PLZ # C3
BLOOMINGTON, IL 61710-0001
Phone:
+1 (309) 763-7085
Fax:
+1 (309) 763-7085
Email:
dan.martin.qlv1@statefarm.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 07/20/2001 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN PET INSURANCE COMPANY
02/16/2018 PCF204502 08/12/2025
AMERICAN PET INSURANCE COMPANY
03/10/2026 PCF204502
ANTHEM HEALTH PLANS OF MAINE INC.
09/01/2015 LHD70566 12/15/2022
ANTHEM LIFE INSURANCE COMPANY
09/01/2015 LHF70467 03/01/2019
ARCADIAN HEALTH PLAN INC
12/08/2016 HMF112421 01/04/2017
ARCADIAN HEALTH PLAN INC
01/06/2017 HMF112421
EMPHESYS INSURANCE COMPANY
11/06/2025 LHF410560
HUMANA INSURANCE COMPANY
11/30/2005 LHF980 12/10/2012
HUMANA INSURANCE COMPANY
01/23/2013 LHF980 01/04/2017
HUMANA INSURANCE COMPANY
01/06/2017 LHF980
JACKSON NATIONAL LIFE INSURANCE COMPANY
05/17/2019 LHF45199
NASSAU LIFE INSURANCE COMPANY
12/13/2005 LHF248 04/09/2013
PACIFIC LIFE INSURANCE COMPANY
06/11/2025 LHF237
STATE FARM FIRE AND CASUALTY COMPANY
05/18/2005 PCF586 05/18/2007
STATE FARM GENERAL INSURANCE COMPANY
05/18/2005 PCF587 05/18/2007
STATE FARM LIFE INSURANCE COMPANY
05/18/2005 LHF25 05/18/2007
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
05/18/2005 PCF588 05/18/2007
TIME INSURANCE COMPANY
07/20/2001 LHF276 08/22/2008
TIME INSURANCE COMPANY
08/07/2009 LHF276 03/15/2021

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
DANIEL M. MARTIN
01/28/2025 PRN338074

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
DANIEL M. MARTIN PRN338074

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
3121011

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 06/05/2026 07:21:01 AM