Agency Information

BROADWAY BENEFITS GROUP LLC

301 W 11 ST

KANSAS CITY, MO 64105

816-399-8578

tim.blackwell@broadwaybenefitsgroup.com

20418105

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	3833077	09/15/2022	Active	09/15/2022	09/30/2025

Qualification Type	Original Issue Date	Status	Effective Date
Health	09/15/2022	Active	09/15/2022
Life	09/15/2022	Active	09/15/2022

Company Name	Appointment Type	Status	Active Date
275
GERBER LIFE INSURANCE COMPANY	Health	Active	10/04/2022
	Life	Active	10/04/2022

row(s) 1 - 2 of 2

Name	Association Type	Agent	Begin Date	End Date
TIMOTHY S BLACKWELL	Designated Resp Lic Prdcr	No	09/15/2022	-

1 - 1