Notification of Changes for Business Entity
General Information
Business Entity Name:	INSPHERE INSURANCE SOLUTIONS, INC
Incorporation / Formation Date:
FEIN:	27-027777-1
Ohio License Number:	39897
NPN:	14412207
DBA / Trade Name:	HEALTHMARKETS INSURANCE AGENCY
State of Domicile:	DE
County:	TARRANT
Business Address
Address 1:	9151 BOULEVARD 26
Address 2:
City:	NORTH RICHLAND HILLS
State:	TX
Zip:	76180
Phone:	817-255-3454
Fax:
Business Web Site Address:
Business Email Address:	ONBOARDING@HEALTHMARKETSHQ.COM
Mailing Address
Address 1:	9151 BOULEVARD 26
Address 2:
City:	NORTH RICHLAND HILLS
State:	TX
Zip:	76180
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	NO	Old Business Entity Name:
New DBA/Trade Name:	NO	New DBA/Trade Name:
Amend DBA/Trade Name:	NO	Old DBA/Trade Name:
Add/Delete Producers, Members, Owners, Partners, Officers and/or Directors:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
ANGELA FULLER	PRODUCER	7440479	YES		04/19/2017
BRANDY DENISE ELLOIE	PRODUCER	17746994	YES		04/19/2017
DUANE HILL	PRODUCER	18200389	YES		04/19/2017
ERIC HAWN	PRODUCER	8695328	YES		04/19/2017
ERIC MATTHEW STANTON	PRODUCER	17286541	YES		04/19/2017
GREGORY K TEIPEL	PRODUCER	8307933	YES		04/19/2017
JAMES L HARPER	PRODUCER	15706577	YES		04/19/2017
LOUIS LEON ELLOIE III	PRODUCER	17993430	YES		04/19/2017
NICOLE SHERWOOD	PRODUCER	18351421	YES		04/19/2017
PHILIP SCHOPICK	PRODUCER	18334706	YES		04/19/2017
RYAN J CALTAGIRONE	PRODUCER	8977234	YES		04/19/2017
WILLIAM J CURLEY	PRODUCER	7815558	YES		04/19/2017
WILLIAM M WOOD	PRODUCER	18220348	YES		04/19/2017

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date

Title Business Entities Only
1. Is any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance? (i.e. banking, auto dealer, mortgage company)	NO
2. Has any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance since the filing of the previous CN-65 or the original application?	NO
3. If the answer to questions #1 or #2 is yes, identify the business or profession and the nature of person's involvement

Submitted By
Submitted By:	JAMES C. MASON
Title:	SR. VICE PRESIDENT
Phone Number:	817-255-3454
Email Address:	ONBOARDING@HEALTHMARKETSHQ.COM