Agency Information

CO-ORDINATED BENEFIT PLANS LLC

Address:

COUNTRYSIDE CORPORATE CENTER

CLEARWATER, FL 33763

Phone

727-799-9188

URL:

Email:

blrsc@cscglobal.com

National Producer Number:

2257434

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Independent Adjuster	4090251	03/05/2025	Active	03/05/2025	03/31/2028
Non-Res. Producer Firm	860896	01/08/2013	Active	01/08/2013	01/31/2028
Non-Res. Third Party Admin.	566067	10/01/2009	Active	10/01/2009	10/31/2025

Qualification Type	Original Issue Date	Status	Effective Date
Adj - Property and Casualty	03/05/2025	Active	03/05/2025
Casualty	01/08/2013	Active	01/08/2013
Health	01/08/2013	Active	01/08/2013
Life	01/08/2013	Active	01/08/2013
Property	01/08/2013	Active	01/08/2013
TPA1 -Life/Health Insurance	10/01/2009	Active	10/01/2009

Company Name	Appointment Type	Status	Active Date
461
NATIONWIDE MUTUAL INSURANCE COMPANY	Casualty	Active	05/08/2018
	Health	Active	10/12/2023
	Property	Active	05/08/2018
692
Company Name	Appointment Type	Status	Active Date
UNITED STATES FIRE INSURANCE COMPANY	Casualty	Active	08/02/2023
	Health	Active	08/02/2023
	Property	Active	08/02/2023

row(s) 1 - 6 of 6

Name	Association Type	Agent	Begin Date	End Date
DEMETRA ELSA WYATT	Designated Resp Lic Adjuster	No	03/05/2025	-
KEVIN HOYLE LEYS	Designated Resp Lic Prdcr	Yes	09/25/2020	-
REBECCA L SIVAK	Designated Resp Lic Prdcr	No	12/17/2024	-

1 - 3