Notification of Changes for Business Entity
General Information
Business Entity Name:	HEALTH OPTION ONE INC
Incorporation / Formation Date:
FEIN:	264718328
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	FL
County:	BROWARD
Business Address
Address 1:	1002 E NEWPORT CENTER DR
Address 2:	SUITE 200
City:	DEERFIELD BEACH
State:	FL
Zip:	33442
Phone:	866-792-5976
Fax:
Business Web Site Address:
Business Email Address:	LICENSING@INSURANCECAREDIRECT.COM
Mailing Address
Address 1:	1002 E NEWPORT CENTER DR
Address 2:	SUITE 200
City:	DEERFIELD BEACH
State:	FL
Zip:	33442
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
PARKER, WAYNE S	PRODUCER	16547390	YES		04/12/2016
DALY, MARK	PRODUCER	12885769	YES		04/12/2016
GREEN, MARK ANTHONY	PRODUCER	16702213	YES		04/12/2016
FREDERIQUE, MELINDA P	PRODUCER	16835185	YES		04/12/2016
BREWER, MICHAEL ALLEN	PRODUCER	14041507	YES		04/12/2016
GENTILE, MICHAEL D	PRODUCER	17402828	YES		04/12/2016
OPHIME, MICHAEL J	PRODUCER	17118758	YES		04/12/2016
KELLY, MICHAEL	PRODUCER	9174505	YES		04/12/2016
VIALVA, RICARDO DAVID	PRODUCER	17232016	YES		04/12/2016
JAROVITS, ROBERT	PRODUCER	16262672	YES		04/12/2016
NAHRA, SALLY LAURA	PRODUCER	16906516	YES		04/12/2016
RODRIGUEZ, SHARENE MAURAYA	PRODUCER	17108296	YES		04/12/2016
SOKOLOWSKI, THOMAS ALAN	PRODUCER	8737586	YES		04/12/2016
FERRARA, VINCENT J	PRODUCER	9185617	YES		04/12/2016
NOCERA, VINCENT COSMO	PRODUCER	16624888	YES		04/12/2016

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)	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:	DANIEL GARAVUSO
Title:	DIRECTOR, COMPLIANCE
Phone Number:	8133971493
Email Address:	DGARAVUSO@HIIQUOTE.COM