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
JOAN ELIZABETH LOCKWOOD	PRODUCER	2598954		YES	01-22-16
KARI ROSS	PRODUCER	17382722		YES	01-22-16
ALVIN DAWKINS	PRODUCER	9263774		YES	01-22-16
STEVEN WURTZ	PRODUCER	17492492		YES	01-22-16
JOHN DANIEL KEITH III	PRODUCER	17408349		YES	01-22-16
ROBERTO MOREL	PRODUCER	16715855		YES	01-22-16
CYNTHIA ANN COUGHENOUR	PRODUCER	17087115		YES	01-22-16
LORI A BROOKS	PRODUCER	16949597		YES	01-22-16
REBECCA HUMBARGER	PRODUCER	17174211		YES	01-22-16
TAMIKA LORRAINE YARBROUGH	PRODUCER	17174211		YES	01-22-16
BRIAN THORNTON	PRODUCER	6816845		YES	01-22-16
CHRIS JON PREITAUER	PRODUCER	3953644		YES	01-22-16
WILLIAM CURLEY	PRODUCER	7815558		YES	01-22-16
RHEA GAYLE JONES	PRODUCER	8734364		YES	01-22-16
HYUN JIN	PRODUCER	17323187		YES	01-22-16

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