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MID MOUNTAIN INSURANCE AGENCY, LLC
Address:
9635 M ST
OMAHA, NE 68127
Phone
402-702-1086
URL:
Pacificbenefitsgroup.com
Email:
mscrivner@fortegra.com
National Producer Number:
1916108
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License Information
License Type
License Number
Original Issue Date
Status
Effective Date
Expiration Date
Non-Res. Producer Firm
587054
03/13/2008
Active
03/13/2008
03/31/2026
Non-Res. Surplus Lines Broker
4120005
06/11/2025
Active
06/11/2025
06/30/2028
Qual Information
Qualification Type
Original Issue Date
Status
Effective Date
Casualty
08/14/2024
Active
08/14/2024
Health
03/13/2008
Active
03/13/2008
Life
03/13/2008
Active
03/13/2008
Property
08/14/2024
Active
08/14/2024
Surplus Lines
06/11/2025
Active
06/11/2025
8 Appointments
43
Company Name
Appointment Type
Status
Active Date
AMERICAN GENERAL LIFE INSURANCE COMPANY
Health
Active
08/26/2012
Life
Active
08/26/2012
104
Company Name
Appointment Type
Status
Active Date
AMERITAS LIFE INSURANCE CORPORATION
Health
Active
10/09/2019
Life
Active
10/09/2019
144156
Company Name
Appointment Type
Status
Active Date
CARE IMPROVEMENT PLUS SOUTH CENTRAL INSURANCE COMPANY
Health
Active
03/23/2025
505
Company Name
Appointment Type
Status
Active Date
CIGNA HEALTH AND LIFE INSURANCE COMPANY
Health
Active
03/04/2020
986
Company Name
Appointment Type
Status
Active Date
GOLDEN RULE INSURANCE COMPANY
Health
Active
04/03/2008
Life
Active
04/03/2008
1281
Company Name
Appointment Type
Status
Active Date
HOMESITE INSURANCE COMPANY
Casualty
Active
03/24/2025
Property
Active
03/24/2025
609
Company Name
Appointment Type
Status
Active Date
STANDARD INSURANCE COMPANY
Health
Active
12/19/2024
Life
Active
12/19/2024
692
Company Name
Appointment Type
Status
Active Date
UNITED STATES FIRE INSURANCE COMPANY
Health
Active
04/04/2018
row(s) 1 - 13 of 13
2 Individual Associations
Name
Association Type
Agent
Begin Date
End Date
BRENDA WESTLUND
Designated Resp Lic Prdcr
Yes
11/14/2024
-
JOHN R KLEMIN
Designated Resp Lic Prdcr
Yes
09/15/2020
-
1 - 2