Notification of Changes for Business Entity
General Information
Business Entity Name:	HUMANA MARKETPOINT AGENCY
Incorporation / Formation Date:
FEIN:	611343508
Ohio License Number:	24204
NPN:
DBA / Trade Name:
State of Domicile:	KY
County:	JEFFERSON
Business Address
Address 1:	500 W MAIN ST.
Address 2:
City:	LOUISVILLE
State:	KY
Zip:	40202
Phone:	502-580-8488
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	500 W MAIN ST.
Address 2:
City:	LOUISVILLE
State:	KY
Zip:	40202
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:	YES

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
ALAN ABREU	AGENT	13083164		YES	03/14/2016
RAFAEL POITIER ABREU	AGENT	17351808		YES	03/14/2016
SCOTT P ALEXANDER	AGENT	3238270		YES	03/14/2016
JOSHUA ALLEYNE	AGENT	15975304		YES	03/14/2016
GIOVANNI CARLO ALONGE	AGENT	3533150		YES	03/14/2016
CARLOS ALVAREZ	AGENT	15975304		YES	03/14/2016
ANTHONY GREGORY ANASTASAS	AGENT	16801245		YES	03/14/2016
STEPHEN ALAN ANDERSON	AGENT	7533065		YES	03/14/2016
TANIA ARAUZ	AGENT	16352708		YES	03/14/2016
MERNAIL ARNOLD-COCHRAN	AGENT	17347796		YES	03/14/2016
NADER ATOUI	AGENT	17004083		YES	03/14/2016
NANCY JOYCE AYRES	AGENT	4884694		YES	03/14/2016
MADELINE G BALL	AGENT	5334220		YES	03/14/2016
WILLIAM E BALLARD	AGENT	8873696		YES	03/14/2016
RICHARD W BANDELOW	AGENT	1750493		YES	03/14/2016

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:	RICK MAYS
Title:	PROCESS MANAGER
Phone Number:	502-580-8488
Email Address:	RMAYS@HUMANA.COM