black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

FIDELITY HEALTH INS SERVICES LLC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN254729
Status:
First Licensure:
08/21/2015
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
FIDELITY EMPLOYES INSURANCE SERVICES LLC
CORPORATION TRUST CENTER
1209 N ORANGE ST
WILMINGTON, DE 19801-1120
Mailing:
2 DESTINY WAY # MZ # WG3D
WESTLAKE, TX 76262-8100
Phone:
+1 (800) 428-5708
Fax:
+1 (517) 333-7129
Email:
fhis@license-support.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 08/21/2015 04/01/2027

Alias, DBA or Trade Name

Name
FIDELITY HEALTH MARKETPLACE

Employer

Name Issue Date License Number Expiration Date Cancel Date
AETNA HEALTH INC
07/20/2024 HMD45749
AMERICAN PROGRESSIVE LIFE & HEALTH INS COMPANY OF NEW YORK
10/04/2022 LHF374 08/25/2023
AMERICAN PROGRESSIVE LIFE & HEALTH INS COMPANY OF NEW YORK
08/28/2023 LHF374
AMERITAS LIFE INSURANCE CORP
04/14/2025 LHF944
AMH HEALTH PLANS OF MAINE, INC.
02/02/2024 LHD353013
AMH HEALTH, LLC
02/02/2024 HMD329485
ANTHEM HEALTH PLANS OF MAINE INC.
02/02/2024 LHD70566
ANTHEM INSURANCE COMPANIES INC
02/02/2024 LHF125537
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE COMPANY
05/26/2022 LHF214634
CIGNA HEALTH AND LIFE INSURANCE COMPANY
12/20/2024 LHF860
EMPIRE HEALTHCHOICE HMO, INC.
02/02/2024 HMF285382
HUMANA INSURANCE COMPANY
08/08/2024 LHF980
MEDCO CONTAINMENT LIFE INSURANCE COMPANY
06/09/2024 LHF183
SIERRA HEALTH AND LIFE INSURANCE COMPANY INC.
05/26/2022 LHF58195
SILVERSCRIPT INSURANCE COMPANY
06/20/2024 LHF132429
UNITEDHEALTHCARE INSURANCE COMPANY
05/26/2022 LHF700
UNITEDHEALTHCARE OF WISCONSIN, INC.
07/20/2022 HMF376407
WELLCARE OF MAINE, INC.
10/04/2022 HMD305081
WELLCARE PRESCRIPTION INSURANCE INC
10/05/2022 LHF121869

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
CONSTANCE OPAL ADKINS
10/05/2021 PRN389861
CATALINA ARREDONDO
02/23/2024 PRN470265
ALCEIDE JOSEPH BERGERON
12/15/2020 PRN361271
MASON BERTRAND
11/22/2021 PRN403463
ERIN MICHELLE BODILY
12/15/2020 PRN345894
MEGAN RYAN BOURQUE
02/24/2020 PRN308181
BRIAN J. BROWN
12/15/2020 PRN165437
ADAM JOSEPH BROWNE
02/23/2024 PRN469640
JENNIFER L. BRYER
12/03/2021 PRN402444
GARY BUTLER
02/23/2024 PRN297122
MARC DANIEL CHOUINARD
02/24/2020 PRN292128
TRAVIS JAMES COCHRAN
04/20/2022 PRN357207
KAREN V. COOMBER
05/22/2019 PRN288348
MARY BETH COUGHLIN
11/22/2021 PRN33710
AAMINA NADEEM DAUDPOTA
04/04/2024 PRN421886
FREDERICK ALEXANDER DAVIS
02/23/2024 PRN440147
HENRY C. DAVIS
02/23/2024 PRN469652
JODY LYN DOBROWSKI
02/24/2020 PRN87950
MICHAEL DRISCOLL
02/24/2020 PRN304301
SARAH EICHORN
12/15/2020 PRN367840
ANTHONY FIERRO
04/20/2022 PRN301102
RICHARD GEBBIA
08/02/2022 PRN420657
SEAN MICHAEL GUTZWILLER
02/23/2024 PRN469657
JULIANNE GREGORY HANSEN
02/23/2024 PRN469653
HEIDI LYNN HARNIST
02/23/2024 PRN469756
STEPHEN MITCHELL HINDSLEY
04/20/2022 PRN388390
DENISE ANN HORTON
02/23/2024 PRN469649
JESSICA LYN HUTCHINGS
02/24/2020 PRN252216
FREDRIC L. JACKSON
04/20/2022 PRN124497
NOAH SAMUEL JACKSON
11/22/2021 PRN403208
KENNETH F. JOHNSON
02/19/2025 PRN139262
BRANDON J LOREN JONES
04/20/2022 PRN213581
MATTHEW A. JOYCE
02/24/2020 PRN347201
ROBERT CALLIS KEISCER
02/23/2024 PRN469757
ROBERT H. KENNEDY
02/24/2020 PRN150205
ERIC M. KIEFFER
03/25/2025 PRN199553
MARY ELLEN LAASE
02/23/2024 PRN352836
AMBER LALLY
12/15/2020 PRN277685
ANGELIQUE LIZOTTE
02/14/2023 PRN395912
CHRISTINA LUECHUNG
02/23/2024 PRN469646
RACHEL R. MACHERA
02/24/2020 PRN142707
GEORGE LAFARRELL MATHIS
02/23/2024 PRN469651
RYAN C. MUNSON
11/22/2021 PRN403352
JEFFREY NARKIEWICZ
02/24/2020 PRN312932
NICHOLAS P. PAULISH
02/24/2020 PRN263604
GREGORY PEEBLES
11/22/2021 PRN403195
LAURIE R. QUINTAL
12/15/2020 PRN347390
JOSE RAMIREZ ROCHA
02/23/2024 PRN358530
FELIX MENDOZA RAMIREZ
02/23/2024 PRN469936
JEREMY P. RANKIN
05/26/2023 PRN118597
THEODIS ALI RASHEED II
02/23/2024 PRN194313
JEFFREY REAVES
05/26/2023 PRN450616
ROBERT ROST
04/04/2024 PRN380528
BRAYDEN SANDBERG
05/26/2023 PRN448745
JENNIFER LYNN SCOTT
05/26/2023 PRN449550
BENJAMIN SEITZ
02/23/2024 PRN320155
JONATHAN DAVID SHELDON
04/04/2024 PRN460714
ALEXANDRIA GLEE SIFUENTES
04/20/2022 PRN305170
AMANDA SIMPSON
02/23/2024 PRN469643
ANDREW STEVENSON
05/26/2023 PRN447203
CHARLES W. STIER III
04/04/2024 PRN74292
COURTNEY SULLIVAN
05/26/2023 PRR448513
MICHAEL J. TERRY
02/24/2020 PRN331276
JOHN THOMPSON
05/26/2023 PRN443146
JOHN JOSEPH THORNTON
05/26/2023 PRN450628
ROBERTO TORRES
02/23/2024 PRN469758
BRADLEY TYSON
02/23/2024 PRN469645
MARK P. VERILLE
02/24/2020 PRN99774
LEE WAGENBORG
02/23/2024 PRN276250
NIKITA WEST
05/26/2023 PRN447418
WAYSON D. WIGHT
11/22/2021 PRN399902
CHRISTOPHER FRANCIS WILSON
02/23/2024 PRN469755
MARCUS ANDREW WINBUSH
02/14/2023 PRN293631
ALLISON K. WOLFE
02/23/2024 PRN469642

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
KAREN V. COOMBER PRN288348

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
17680352

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 07:16:31 AM