Notification of Changes for Business Entity
General Information
Business Entity Name:	HUMANA PHARMACY SOLUTIONS, INC.
Incorporation / Formation Date:
FEIN:	45-2254346
Ohio License Number:	934973
NPN:
DBA / Trade Name:
State of Domicile:	KY
County:	JEFFERSON
Business Address
Address 1:	500 WEST MAIN STREET
Address 2:
City:	LOUISVILLE
State:	KY
Zip:	40202
Phone:	5025801000
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	321 WEST MAIN STREET, WFP-7E
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

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
JAMES E. MURRAY	DIRECTOR	289544483		YES	3-31-2017
BRIAN A. KANE	DIRECTOR	183522590	YES		4-1-2017

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)
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?
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:	J. GREGORY CATRON (BY J.ERWIN)
Title:	VICE PRESIDENT AND CHIEF COMPLIANCE OFFICER
Phone Number:	502-476-1143
Email Address:	JERWIN3@HUMANA.COM