black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

PREMIER WORK-SITE SOLUTIONS

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN523564
Status:
First Licensure:
08/13/2025
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
700 KINDERKAMACK RD STE 205
ORADELL, NJ 07649-1533
Mailing:
700 KINDERKAMACK RD STE 205
ORADELL, NJ 07649-1533
Phone:
+1 (866) 463-8801
Fax:
+1 (866) 567-7189
Email:
mborella@premierworksite.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 08/13/2025 04/01/2027

Alias, DBA or Trade Name

Name
PREMIER WORKSITE BENEFITS

Employer

Name Issue Date License Number Expiration Date Cancel Date
PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY
08/14/2025 LHF250
STARMOUNT LIFE INSURANCE COMPANY
08/14/2025 LHD131525
UNUM INSURANCE COMPANY
08/14/2025 LHD241
UNUM LIFE INSURANCE COMPANY OF AMERICA
08/14/2025 LHD145

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
MATTHEW LUKE BORELLA
08/13/2025 PRN90607

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
MATTHEW LUKE BORELLA PRN90607

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
13812180

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: 12/24/2025 03:06:37 AM