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
JEREMY A STERN	PRODUCER	7818534	YES		06-13-16
JEREMY RYAN LYNCH	PRODUCER	17718501	YES		06-13-16
JOHN CAMERON ROACH	PRODUCER	17434924	YES		06-13-16
KELLY NIEMANN	PRODUCER	17028964	YES		06-13-16
LAURA CAVANAUGH	PRODUCER	17949113	YES		06-13-16
LEONA JEFFRIES	PRODUCER	17792528	YES		06-13-16
MATTHEW J RIEGERT	PRODUCER	12929361	YES		06-13-16
NORMA OLVERA	PRODUCER	16873876	YES		06-13-16
RICK C PETERSON	PRODUCER	722554	YES		06-13-16
SARA ELEANOR ALEXANDER	PRODUCER	17749882	YES		06-13-16
SHERYL K NOBLITT	PRODUCER	13497375	YES		06-13-16
STEPHEN W JARAS	PRODUCER	2334543	YES		06-13-16
STEPHEN WEINBERGER	PRODUCER	15048491	YES		06-13-16
TRAVIS LEE WOODS	PRODUCER	3237391	YES		06-13-16
TUAN ENGLAND PHAM	PRODUCER	16306111	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