black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

EMPLOYEE BENEFITS DESIGN INC

RESIDENT PRODUCER AGENCY

License Number:
AGR104732
Status:
Active
First Licensure:
06/24/2004
Cancel Date:
None
Renewal Date:
12/01/2026

Street Location:
424 STRICKLAND RD
FORT FAIRFIELD, ME 04742-3024
Mailing:
C/O BRENT D CHURCHILL
424 STRICKLAND RD
FORT FAIRFIELD, ME 04742-3024
Phone:
+1 (207) 472-4332
Fax:
+1 (207) 472-4330
Email:
bchurchill@empbenefits.com

History
License Type Start Date End Date
RESIDENT PRODUCER AGENCY 06/24/2004 12/01/2026

Employer
Name Issue Date License Number Expiration Date Cancel Date
AETNA HEALTH INC
 12/17/2015 HMD45749 07/06/2022
AETNA LIFE INSURANCE COMPANY
 12/17/2015 LHF621 07/06/2022
AMERICAN FAMILY LIFE ASSURANCE COMPANY OF COLUMBUS
 07/27/2007 LHF645 08/31/2008
AMERITAS LIFE INSURANCE CORP
 12/27/2017 LHF944 06/03/2021
ANTHEM HEALTH PLANS OF MAINE INC.
 07/01/2004 LHD70566
ANTHEM INSURANCE COMPANIES INC
 07/06/2006 LHF125537 10/16/2012
ANTHEM LIFE INSURANCE COMPANY
 07/15/2004 LHF70467 04/11/2025
BANNER LIFE INSURANCE COMPANY
 12/01/2008 LHF50047
CONNECTICUT GENERAL LIFE INSURANCE COMPANY
 06/13/2011 LHF149 09/25/2014
GENWORTH LIFE & ANNUITY INSURANCE COMPANY
 07/23/2009 LHF966 03/07/2012
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY
 08/23/2005 LHF193
HARTFORD LIFE GROUP INSURANCE COMPANY
 08/23/2005 LHF47085 12/31/2006
LIFE INSURANCE COMPANY OF NORTH AMERICA
 05/16/2018 LHF205
THE LINCOLN NATIONAL LIFE INSURANCE COMPANY
 12/14/2017 LHF619
MAINE DENTAL SERVICE CORP
 02/17/2022 NPD29330
MAINE PARTNERS HEALTH PLAN INC
 07/01/2004 HMD51090 12/31/2004
METROPOLITAN LIFE INSURANCE COMPANY
 05/10/2018 LHF380
RELIASTAR LIFE INSURANCE COMPANY
 05/08/2018 LHF22
STANDARD INSURANCE COMPANY
 01/24/2025 LHF991
SUN LIFE AND HEALTH INSURANCE COMPANY (US)
 04/16/2009 LHF857 08/10/2011
SUN LIFE ASSURANCE COMPANY OF CANADA - US BRANCH
 04/16/2009 LHF271
SYMETRA LIFE INSURANCE COMPANY
 12/29/2004 LHF777 09/12/2014
UNION SECURITY INSURANCE COMPANY
 06/01/2016 LHF295 12/04/2020
UNITEDHEALTHCARE INSURANCE COMPANY
 11/17/2017 LHF700 08/12/2025
UNITEDHEALTHCARE OF NEW ENGLAND, INC.
 11/01/2021 HMF393375 08/12/2025

Affiliated Agent
Name Issue Date License Number Expiration Date Cancel Date
BRENT DUANE CHURCHILL
 06/24/2004 PRR16518

Branch Office

None.

Supervised Entity

None.

Responsible Individual
Name License Number
BRENT DUANE CHURCHILL PRR16518

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
8152796

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: 02/15/2026 04:25:27 PM