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
AMBER DAWN CARPENTER	PRODUCER	17835633	YES		06-13-16
ANTHONY MICHEAL FOGGS	PRODUCER	13211582	YES		06-13-16
ARAYA INGE	PRODUCER	17878029	YES		06-13-16
BETHANY KAYE BARRETT	PRODUCER	17420975	YES		06-13-16
BRADLEY THOMAS HUNTER	PRODUCER	7285060	YES		06-13-16
BRANDON MONTY	PRODUCER	16453896	YES		06-13-16
BRIAN ADELSTEIN	PRODUCER	8235176	YES		06-13-16
CLIFFORD J PUGH	PRODUCER	17857707	YES		06-13-16
CLINTON R COOPER	PRODUCER	8752631	YES		06-13-16
DAVID BRYAN LEVENGOOD	PRODUCER	3999956	YES		06-13-16
DAVID SELLERS	PRODUCER	17839503	YES		06-13-16
DENIS J CHABOT	PRODUCER	17341015	YES		06-13-16
DREW MOSLEY	PRODUCER	17098828	YES		06-13-16
FRED WHEELER	PRODUCER	16902807	YES		06-13-16
HOWARD PRATT	PRODUCER	1791432	YES		06-13-16

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