black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

DAVID E. KELLY

PRODUCER NON-RESIDENT

License Number:
PRN76833
Status:
First Licensure:
03/12/2001
Cancel Date:
None

Mailing:
SPARKS, MD 21152
Phone:
+1 (410) 527-3400
Fax:
+1 (410) 527-3421
Email:
mdonatelli@kellybenefits.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 03/12/2001

Agency

Name Issue Date License Number Expiration Date Cancel Date
KELLY & ASSOCIATES INSURANCE GROUP INC
06/16/2005 AGN115182
KELLY BENEFITS WORKERS COMPENSATION, INC.
03/28/2007 AGN138198

Employer

Name Issue Date License Number Expiration Date Cancel Date
EMPLOYERS ASSURANCE COMPANY
05/07/2024 PCF285638
EMPLOYERS COMPENSATION INSURANCE COMPANY
05/07/2024 PCF285639
EMPLOYERS PREFERRED INSURANCE COMPANY
05/07/2024 PCF285637
FIDELITY SECURITY LIFE INSURANCE COMPANY
05/23/2013 LHF972
FIRST COLONY LIFE INSURANCE COMPANY
04/11/2003 LHF175 07/06/2005
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY
06/30/2021 LHF193
HUMANA INSURANCE COMPANY
07/20/2010 LHF980 03/02/2020
HUMANADENTAL INSURANCE COMPANY
05/26/2011 LHF173873 03/02/2020
MADISON NATIONAL LIFE INSURANCE COMPANY
07/28/2010 LHF120427 10/20/2017
METROPOLITAN LIFE INSURANCE COMPANY
04/23/2003 LHF380 06/07/2015
MUTUAL OF OMAHA INSURANCE COMPANY
01/27/2011 LHF84
NATIONAL GUARDIAN LIFE INSURANCE COMPANY
03/26/2021 LHF84860
NATIONWIDE LIFE INSURANCE COMPANY
03/29/2021 LHF29
NORGUARD INSURANCE COMPANY
08/31/2016 PCF51459
PRUDENTIAL INSURANCE COMPANY OF AMERICA
04/25/2001 LHF252 02/01/2004
TIME INSURANCE COMPANY
06/24/2011 LHF276 06/25/2015
UNITED OF OMAHA LIFE INSURANCE COMPANY
01/27/2011 LHF28
UNITED STATES FIRE INSURANCE COMPANY
09/12/2017 PCF101256 12/29/2021
UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NY
11/22/2002 LHF654 08/01/2009
WEST COAST LIFE INSURANCE COMPANY
04/18/2003 LHF47439 03/07/2008

Authority

Description Issue Date Termination Date Status
CASUALTY 11/10/2005 Active
HEALTH 03/12/2001 Active
LIFE 03/12/2001 Active
PROPERTY 11/10/2005 Active

Responsible For

Name License Number
KELLY & ASSOCIATES INSURANCE GROUP INC AGN115182
KELLY BENEFITS WORKERS COMPENSATION, INC. AGN138198

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
2061126

Other Addresses

Address Type
SPARKS, MD 21152
Office

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: 05/14/2025 01:10:44 AM