Notification of Changes for Business Entity
General Information
Business Entity Name:	HUMANA MARKETPOINT
Incorporation / Formation Date:
FEIN:	611343508
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	KY
County:	JEFFERSON
Business Address
Address 1:	500 W MAIN STREET
Address 2:
City:	LOUISVILLE
State:	KY
Zip:	40202
Phone:	5024762445
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	500 W MAIN STREET
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
JENNIFER THORNHILL	AGENT	3138839	YES		08/16/2016
TYLER WARE	AGENT	17659466	YES		08/16/2016
WILLIAM POUNDS	AGENT	17693675	YES		08/16/2016
SABRINA SOLIS	AGENT	17693556	YES		08/16/2016
SEYMOUR MESSAM	AGENT	13653542	YES		08/16/2016
CHRISTOPHER METZ	AGENT	17669160	YES		08/16/2016
VICTOR MILLS	AGENT	16121088	YES		08/16/2016
CHEMETRIA MUNN	AGENT	17654109	YES		08/16/2016
NEHA PRASAD	AGENT	17663994	YES		08/16/2016
ERIKA PRIETO	AGENT	17692202	YES		08/16/2016
BOBBI RAMOS	AGENT	17694793	YES		08/16/2016
SABLE RICHARDS	AGENT	17693139	YES		08/16/2016
ANDREW LEBON	AGENT	8596356	YES		08/16/2016

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)
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?
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:	STACY RAYBURN
Title:	COMPLIANCE ANALYST
Phone Number:	5024762445
Email Address:	SRAYBURN@HUMANA.COM