black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

BRENT DUANE CHURCHILL

PRODUCER RESIDENT

License Number:
PRR16518
Status:
First Licensure:
05/14/1984
Cancel Date:
None
Renewal Date:
05/31/2026

Continuing Education:
Required by 05/31/2026
Hours Required:
Ethics:
3
Total Required:
24
Hours Acquired:
Ethics:
0
Total Acquired:
0

Mailing:
FORT FAIRFIELD, ME 04742
Phone:
+1 (207) 472-4332
Fax:
+1 (207) 472-4330
Email:
bchurchill@empbenefits.com

History

License Type Start Date End Date
PRODUCER RESIDENT 05/14/1984 05/31/2026

Agency

Name Issue Date License Number Expiration Date Cancel Date
EMPLOYEE BENEFITS DESIGN INC
06/24/2004 AGR104732

Employer

Name Issue Date License Number Expiration Date Cancel Date
AETNA HEALTH INC
11/02/2000 HMD45749 07/07/2022
AETNA LIFE INSURANCE COMPANY
10/15/1992 LHF621 07/07/2022
AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS
03/18/2003 LHF645 05/18/2004
AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS
07/27/2007 LHF645 08/31/2008
AMERICAN GENERAL LIFE INSURANCE COMPANY
05/19/2014 LHF119
AMERICAN UNITED LIFE INSURANCE COMPANY
01/24/2003 LHF35996 05/14/2015
AMERITAS LIFE INSURANCE CORP
12/16/2017 LHF944 06/03/2021
ANTHEM HEALTH PLANS OF MAINE INC.
05/25/2000 LHD70566
ANTHEM INSURANCE COMPANIES INC
07/01/2006 LHF125537 10/26/2012
ANTHEM LIFE INSURANCE COMPANY
04/26/2011 LHF70467 04/17/2025
BANNER LIFE INSURANCE COMPANY
12/01/2008 LHF50047
CIGNA HEALTHCARE OF MAINE INC.
07/30/1999 HMD4 04/22/2014
COMPANION LIFE INSURANCE COMPANY
02/02/2009 LHF89767 09/23/2012
CONNECTICUT GENERAL LIFE INSURANCE COMPANY
07/30/1999 LHF149 05/16/2014
DEARBORN LIFE INSURANCE COMPANY
01/14/2005 LHF919 10/18/2013
GENWORTH LIFE & ANNUITY INSURANCE COMPANY
08/05/2009 LHF966 05/14/2012
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY
08/23/2005 LHF193 12/03/2009
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY
12/14/2009 LHF193 09/24/2012
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY
10/24/2012 LHF193
JOHN ALDEN LIFE INSURANCE COMPANY
01/28/2002 LHF724 11/11/2009
LIFE INSURANCE COMPANY OF NORTH AMERICA
05/16/2018 LHF205
LINCOLN NATIONAL LIFE INSURANCE COMPANY-THE
12/14/2017 LHF619
MAINE COMMUNITY HEALTH OPTIONS
08/01/2014 NPD214118
MAINE DENTAL SERVICE CORP
02/24/2020 NPD29330
MEDICAL LIFE INSURANCE COMPANY
02/01/2001 LHF1016 12/31/2004
METROPOLITAN LIFE INSURANCE COMPANY
08/12/1999 LHF380 04/07/2017
METROPOLITAN LIFE INSURANCE COMPANY
05/09/2018 LHF380
NASSAU LIFE INSURANCE COMPANY
02/01/1991 LHF248 06/08/2007
PATRIOT INSURANCE COMPANY
01/01/2002 PCD208274 07/01/2005
PRUDENTIAL INSURANCE COMPANY OF AMERICA
04/03/1998 LHF252
RED TREE INSURANCE COMPANY INC
04/07/2021 LHF174438
RELIASTAR LIFE INSURANCE COMPANY
08/12/2003 LHF22 07/27/2005
RELIASTAR LIFE INSURANCE COMPANY
05/08/2018 LHF22
THE SAVINGS BANK MUTUAL LIFE INSURANCE COMPANY OF MASSACHUSETTS
08/23/2016 LHF50668 07/21/2020
SECURITY CONNECTICUT LIFE INSURANCE COMPANY
09/30/1998 LHF876 10/01/2003
SUN LIFE AND HEALTH INSURANCE COMPANY (US)
06/03/2003 LHF857
SUN LIFE ASSURANCE COMPANY OF CANADA - US BRANCH
04/16/2009 LHF271
SYMETRA LIFE INSURANCE COMPANY
12/29/2004 LHF777 03/06/2014
UNION SECURITY INSURANCE COMPANY
06/01/2016 LHF295
UNITED OF OMAHA LIFE INSURANCE COMPANY
04/02/2015 LHF28 07/22/2016
UNITED STATES LIFE INSURANCE COMPANY IN THE CITY OF NY
01/01/1993 LHF654 02/28/2006
UNITEDHEALTHCARE INSURANCE COMPANY
11/17/2017 LHF700
UNITEDHEALTHCARE OF NEW ENGLAND, INC.
11/01/2021 HMF393375
UNUM LIFE INSURANCE COMPANY OF AMERICA
01/08/1992 LHD145 05/20/2005

Authority

Description Issue Date Termination Date Status
HEALTH 02/27/1984 Active
LIFE 02/27/1984 Active

Responsible For

Name License Number
EMPLOYEE BENEFITS DESIGN INC AGR104732

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
3299797

Other Addresses

Address Type
FORT FAIRFIELD, ME 04742
Office

CE Courses

None.

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: 06/15/2025 07:06:21 AM