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
DYANNE MITCHELL	PRODUCER	752334		YES	05/18/16
EDWARD G SULLIVAN	PRODUCER	2209501		YES	05/18/16
EMMANUEL PAUL BROUSSARD	PRODUCER	6745764		YES	05/18/16
ENRIQUE G BARAJAS	PRODUCER	17183438		YES	05/18/16
FAY MARY HAAS	PRODUCER	17775425		YES	05/18/16
FRANCIS MICHAEL LILLIS	PRODUCER	16960225		YES	05/18/16
GABRIELLE FIORE	PRODUCER	15824436		YES	05/18/16
GLORIA G GARZA	PRODUCER	1087948		YES	05/18/16
GREGORY ALLEN GRAF	PRODUCER	1282961		YES	05/18/16
HAROLD LEROY WALKER	PRODUCER	9077569		YES	05/18/16
I V J ANDERSON JR	PRODUCER	8782528		YES	05/18/16
ISAAC AJAYI	PRODUCER	16710935		YES	05/18/16
JAMES BROWN LOMAX	PRODUCER	17045777		YES	05/18/16
JENNIFER E COGHLAN	PRODUCER	17691930		YES	05/18/16
JEROME LAYTON	PRODUCER	2434268		YES	05/18/16

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