black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

EMPLOYEE BENEFIT/RISK MANAGEMENT SERVICES, LLC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN410566
Status:
First Licensure:
02/15/2022
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
100 OTTAWA AVE SW
GRAND RAPIDS, MI 49503-5087
Mailing:
800
PO BOX 1788
GRAND RAPIDS, MI 49501-1788
Phone:
+1 (800) 801-2300
Fax:
+1 (818) 575-2337
Email:
wpregulatorylicensing@warnerpacific.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 07/22/2025 04/01/2027
*** NOT ACTIVE *** 04/01/2025 07/21/2025
NON-RESIDENT PRODUCER AGENCY 02/15/2022 03/31/2025

Employer

None.

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
JOHN JEFFREY NELSON
07/22/2025 PRN415504

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
JOHN JEFFREY NELSON PRN415504

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
20199317

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: 08/05/2026 02:59:44 PM