Notification of Changes for Business Entity
General Information
Business Entity Name:	HUMANA MARKETPOINT AGENCY
Incorporation / Formation Date:
FEIN:	611343508
Ohio License Number:	24204
NPN:
DBA / Trade Name:
State of Domicile:	KY
County:	JEFFERSON
Business Address
Address 1:	500 W MAIN ST.
Address 2:
City:	LOUISVILLE
State:	KY
Zip:	40202
Phone:	502-476-3149
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	500 W MAIN ST.
Address 2:
City:	LOUISVILLE
State:	KY
Zip:	40202
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
TIFFANY THERESA SPRINGER-DUBER	AGENT	9185671		YES	03/17/2016
JAMES BERNARD MARTIN	AGENT	7898412		YES	03/17/2016
BARBARA MARIE FEY	AGENT	6625066		YES	03/17/2016
PATRICIA ROSARIO	AGENT	8355393		YES	03/17/2016
RONALD L HEBERT	AGENT	8002685		YES	03/17/2016
MARGARET J CAUDILL	AGENT	8969145		YES	03/17/2016
MICHAEL J SCHWENKNER	AGENT	310249		YES	03/17/2016
JOEL PAUL MCCARTNEY LEUNG	AGENT	11163788		YES	03/17/2016
MIRJANA JOCIC	AGENT	9858366		YES	03/17/2016
DENISE L GRANT	AGENT	15485359		YES	03/17/2016
RAQUEL ALEMAN JUOZAPAITIS	AGENT	8946276		YES	03/17/2016
ANTONIO FRANCO CICERO	AGENT	7832391		YES	03/17/2016
WILLIAM JAY SMITH	AGENT	17369271		YES	03/17/2016
APRILLYNN LOCICERO LLOYD	AGENT	17019165		YES	03/17/2016
ROBERT B THORNE	AGENT	408636		YES	03/17/2016

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:	RHONDA WINFORD
Title:	CONTRACTING ANALYST
Phone Number:	502-476-3149
Email Address:	RWINFORD@HUMANA.COM