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:	5025808488
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
JAMES B ADKINS	AGENT	14449934	YES		03/16/2016
JOANNE B ALLEN	AGENT	7650402	YES		03/16/2016
TERRY A ALLISON	AGENT	102728	YES		03/16/2016
KYLE ALMENDAREZ	AGENT	17062102	YES		03/16/2016
LESLIE A ANDERS	AGENT	1057472	YES		03/16/2016
EDWARD J ANDRADE	AGENT	599649	YES		03/16/2016
DEBRA J ANSTICE	AGENT	8710644	YES		03/16/2016
ARACELYS ARANA-TREVINO	AGENT	9499305	YES		03/16/2016
ROBERT G BAUMANN	AGENT	7381046	YES		03/16/2016
YVETTE M BENITEZ	AGENT	9576327	YES		03/16/2016
JEREMY K BESORE	AGENT	15798805	YES		03/16/2016
MARISA N BEWRY	AGENT	8954559	YES		03/16/2016
RICHARD H BLACKFORD	AGENT	15782691	YES		03/16/2016
D ARLENE BOISROND	AGENT	17322534	YES		03/16/2016
BRIAN BOYD	AGENT	17029288	YES		03/16/2016

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