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:	N. 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:	N. 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
GWENDOLYN DUKES	PRODUCER	16117174		YES	10-19-16
RUSSELL REED II	PRODUCER	17708322		YES	10-19-16
HOWARD PRATT	PRODUCER	1791432		YES	10-19-16
JUAN MARTIN ESCOTO	PRODUCER	14897048		YES	10-19-16
JOHN THOMPSON JR	PRODUCER	17627059		YES	10-19-16
ARAYA INGE	PRODUCER	17878029		YES	10-19-16
JULIE GOULD	PRODUCER	17061491		YES	10-19-16
ASHLEY VANDYKE	PRODUCER	16691913		YES	10-19-16
GRACE WILLIAMSON	PRODUCER	17800122		YES	10-19-16
MAISA KINGSTONE	PRODUCER	15813022		YES	10-19-16
TAREQ R ALABBASI	PRODUCER	13057373		YES	10-19-16
AARON DAVID ST JOHN	PRODUCER	16130738		YES	10-19-16
NICKOL A WILSON	PRODUCER	17393140		YES	10-19-16
JOSEPH M EUKOVICH	PRODUCER	2985883		YES	10-19-16
CASEY NICOLE HOWARD	PRODUCER	17781372		YES	10-19-16

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:	817-255-3464
Email Address:	ONBOARDING@HEALTHMARKETSHQ.COM