Under the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless it displays a valid OMB control number.
`PTO Form 1478 (Rev 09/2006)
`
`OMB No. 0651-0009 (Exp 02/28/2021)
`
`Trademark/Service Mark Application, Principal Register
`
`TEAS Plus Application
`
`Serial Number: 88644617
`Filing Date: 10/07/2019
`
`NOTE: Data fields with the * are mandatory under TEAS Plus. The wording "(if applicable)" appears where the field is only mandatory
`under the facts of the particular application.
`
`The table below presents the data as entered.
`
`Entered
`
`Input Field
`
`TEAS Plus
`
`YES
`
`MARK INFORMATION
`
`*MARK
`
`HEALTHCARE SOLUTIONS DIRECT SIMPLE AS 1-2-3
`
`*STANDARD
`CHARACTERS
`
`YES
`
`USPTO-GENERATED
`IMAGE
`
`YES
`
`LITERAL ELEMENT HEALTHCARE SOLUTIONS DIRECT SIMPLE AS 1-2-3
`
`*MARK
`STATEMENT
`
`REGISTER
`
`The mark consists of standard characters, without claim to any particular font style, size, or color.
`
`Principal
`
`APPLICANT INFORMATION
`
`*OWNER OF MARK HEALTHCARE SOLUTIONS DIRECT, LLC
`
`*STREET
`
`*CITY
`
`*STATE
`(Required for U.S.
`applicants)
`
`3350 BUSCHWOOD PARK DR, SUITE 150
`
`TAMPA
`
`Florida
`
`*COUNTRY
`
`United States
`
`*ZIP/POSTAL CODE
`(Required for U.S. and
`certain international
`addresses)
`
`33618
`
`WEBSITE ADDRESS
`
`https://www.medicaremedigap.com/
`
`LEGAL ENTITY INFORMATION
`
`*TYPE
`
`LIMITED LIABILITY COMPANY
`
`* STATE/COUNTRY
`WHERE LEGALLY
`ORGANIZED
`
`Florida
`
`GOODS AND/OR SERVICES AND BASIS INFORMATION
`
`* INTERNATIONAL
`
`036 
`
`

`

`CLASS
`
`*IDENTIFICATION
`
`Advisory services in the field of employee benefits for group healthcare and business insurance offered to
`employees in addition to standard benefits such as medical, dental, life insurance including short term disability,
`long term disability, cancer insurance, accidental death and dismemberment; Insurance services, namely, providing
`information and on-line computer databases for the purpose of review and verification of Medicaid and Medicare
`eligibility status and related information; Insurance services, namely, providing information and on-line computer
`databases for the purpose of review and verification of Medicaid eligibility status and related information; Insurance
`services, namely, providing information and on-line computer databases for the purpose of review and verification
`of Medicare eligibility status and related information; Insurance and financial information and consultancy services;
`Insurance services, namely, insurance eligibility review and verification and consultation in the health insurance,
`dental insurance, and life insurance industry; Issuance of health, dental, and life insurance; Medical insurance
`case and utilization review and insurance claims adjustment services for healthcare purchasers and payors and
`providers and Medicare beneficiaries; Social security and Medicare claims administration and consulting services
`rendered to individuals; Providing information about healthcare insurance plans
`
`*FILING BASIS
`
`SECTION 1(a)
`
`       FIRST USE
`ANYWHERE DATE
`
`At least as early as 02/15/2015
`
`       FIRST USE IN
`COMMERCE DATE At least as early as 02/15/2015
`
`       SPECIMEN FILE NAME(S)
`
`       JPG FILE(S)
`
`\\TICRS\EXPORT17\IMAGEOUT 17\886\446\88644617\xml1\ FTK0007.JPG
`
`       ORIGINAL PDF
`FILE
`
`       CONVERTED
`PDF FILE(S)
`       (1 page)
`
`       ORIGINAL PDF
`FILE
`
`       CONVERTED
`PDF FILE(S)
`       (1 page)
`
`       ORIGINAL PDF
`FILE
`
`       CONVERTED
`PDF FILE(S)
`       (1 page)
`
`       ORIGINAL PDF
`FILE
`
`       CONVERTED
`PDF FILE(S)
`       (1 page)
`
`       SPECIMEN
`DESCRIPTION
`
`SPE0-979623164-20191007134909570723_._Specimen_A_-_Organizer.pdf
`
`\\TICRS\EXPORT17\IMAGEOUT17\886\446\88644617\xml1\FTK0003.JPG
`
`SPE0-979623164-20191007134909570723_._Specimen_B_-_Original_Business_Card.pdf
`
`\\TICRS\EXPORT17\IMAGEOUT17\886\446\88644617\xml1\FTK0004.JPG
`
`SPE0-979623164-20191007134909570723_._Specimen_C_-_Letter_ENC_Organizer.pdf
`
`\\TICRS\EXPORT17\IMAGEOUT17\886\446\88644617\xml1\FTK0005.JPG
`
`SPE0-979623164-20191007134909570723_._Specimen_D_-_Healthcare_Solutions_Direct_Poster.pdf
`
`\\TICRS\EXPORT17\IMAGEOUT17\886\446\88644617\xml1\FTK0006.JPG
`
`The attached Specimen A is an organizer bearing the applied-for mark being used on applicant's marketing
`materials, including to customers in order to keep all three of their health insurance cards in it, including Medicare
`and Medicaid cards. The attached Specimen B is the original business card bearing the applied-for mark being used
`on commerce. The attached Specimen C is the original letter bearing the applied-for mark being used on applicant's
`marketing materials, including to include with letters to customers enclosing the organizer depicted in Specimen A.
`The attached Specimen D is a poster bearing the applied-for mark being used on applicant's internal business
`materials, this serving as a reminder to employees of the applicant's business services provided to the healthcare
`industry. The attached Specimen E is the applicant's logo bearing the applied-for mark and being used in commerce.
`
`ADDITIONAL STATEMENTS SECTION
`
`*TRANSLATION
`(if applicable)
`
`*T
`
`RANSLITERATION
`(if applicable)
`
` 
` 
`

`

`*CLAIMED PRIOR
`REGISTRATION
`(if applicable)
`
`*CONSENT
`(NAME/LIKENESS)
`(if applicable)
`
`*CONCURRENT USE
`CLAIM
`(if applicable)
`
`USE OF THE MARK
`IN ANOTHER FORM
`
`The mark was first used anywhere in a different form other than that sought to be registered at least as early as
`02/15/2015, and in commerce at least as early as 02/15/2015.
`
`MISCELLANEOUS
`STATEMENT
`
`The mark was first used anywhere in a different form other than that sought to be registered at least as early as
`February 15, 2015, and in commerce at least as early as February 15, 2015. That form was: Medicare is As Simple
`As 1-2-3. The mark is associated with TEAS PLUS Application, Registration Number 88644584.
`
`       MISCELLANEOUS FILE NAME(S)
`
`       ORIGINAL PDF
`FILE
`
`       CONVERTED
`PDF FILE(S)
`       (1 page)
`
`MIS-979623164-20191005034543043541_._hcare_Solutions_Direct_Original_Front_and_Back_Business_Card.pdf
`
`\\TICRS\EXPORT17\IMAGEOUT17\886\446\88644617\xml1\FTK0008.JPG
`
`ATTORNEY INFORMATION
`
`NAME
`
`DOMENICK LAZARA
`
`ATTORNEY BAR
`MEMBERSHIP
`NUMBER
`
`YEAR OF
`ADMISSION
`
`XXX
`
`XXXX
`
`U.S. STATE/
`COMMONWEALTH/
`TERRITORY
`
`XX
`
`FIRM NAME
`
`DOM LAW, PA
`
`STREET
`
`CITY
`
`STATE
`
`1814 NORTH 15TH STREET
`
`TAMPA
`
`Florida
`
`COUNTRY
`
`United States
`
`ZIP/POSTAL CODE
`
`33605
`
`PHONE
`
`FAX
`
`813-606-5036
`
`813-606-5336
`
`EMAIL ADDRESS
`
`DOM@DOMLAW.COM
`
`AUTHORIZED TO
`COMMUNICATE
`VIA EMAIL
`
`Yes
`
`CORRESPONDENCE INFORMATION
`
`*NAME
`
`DOMENICK LAZARA
`
`FIRM NAME
`
`DOM LAW, PA
`
`*STREET
`
`*CITY
`
`1814 NORTH 15TH STREET
`
`TAMPA
`
` 
` 
`

`

`*STATE
`(Required for U.S.
`addresses)
`
`Florida
`
`*COUNTRY
`
`United States
`
`*ZIP/POSTAL CODE 33605
`
`PHONE
`
`FAX
`
`813-606-5036
`
`813-606-5336
`
`*EMAIL ADDRESS
`
`DOM@DOMLAW.COM
`
`*AUTHORIZED TO
`COMMUNICATE
`VIA EMAIL
`
`Yes
`
`FEE INFORMATION
`
`APPLICATION
`FILING OPTION
`
`NUMBER OF
`CLASSES
`
`FEE PER CLASS
`
`*TOTAL FEE PAID
`
`TEAS Plus
`
`1
`
`225
`
`225
`
`SIGNATURE INFORMATION
`
`* SIGNATURE
`
`/DOMENICK G. LAZZARA/
`
`* SIGNATORY'S
`NAME
`
`* SIGNATORY'S
`POSITION
`
`SIGNATORY'S
`PHONE NUMBER
`
`DOMENICK G. LAZZARA, OBO HEALTHCARE SOLUTIONS DIRECT, LLC
`
`ATTORNEY OF RECORD, FLA. BAR NO. 0103071
`
`813-606-5036
`
`* DATE SIGNED
`
`10/07/2019
`
`

`

`Under the Paperwork Reduction Act of 1995 no persons are required to respond to a collection of information unless it displays a valid OMB control number.
`PTO Form 1478 (Rev 09/2006)
`
`OMB No. 0651-0009 (Exp 02/28/2021)
`
`Trademark/Service Mark Application, Principal Register
`
`TEAS Plus Application
`
`Serial Number: 88644617
`Filing Date: 10/07/2019
`
`To the Commissioner for Trademarks:
`
`MARK: HEALTHCARE SOLUTIONS DIRECT SIMPLE AS 1-2-3 (Standard Characters, see mark)
`The literal element of the mark consists of HEALTHCARE SOLUTIONS DIRECT SIMPLE AS 1-2-3. The mark consists of standard characters,
`without claim to any particular font style, size, or color.
`The applicant, HEALTHCARE SOLUTIONS DIRECT, LLC, a limited liability company legally organized under the laws of Florida, having an
`address of
`      3350 BUSCHWOOD PARK DR, SUITE 150
`      TAMPA, Florida 33618
`      United States
`
`requests registration of the trademark/service mark identified above in the United States Patent and Trademark Office on the Principal Register
`established by the Act of July 5, 1946 (15 U.S.C. Section 1051 et seq.), as amended, for the following:
`
`For specific filing basis information for each item, you must view the display within the Input Table.
`International Class 036:  Advisory services in the field of employee benefits for group healthcare and business insurance offered to employees in
`addition to standard benefits such as medical, dental, life insurance including short term disability, long term disability, cancer insurance,
`accidental death and dismemberment; Insurance services, namely, providing information and on-line computer databases for the purpose of
`review and verification of Medicaid and Medicare eligibility status and related information; Insurance services, namely, providing information
`and on-line computer databases for the purpose of review and verification of Medicaid eligibility status and related information; Insurance
`services, namely, providing information and on-line computer databases for the purpose of review and verification of Medicare eligibility status
`and related information; Insurance and financial information and consultancy services; Insurance services, namely, insurance eligibility review
`and verification and consultation in the health insurance, dental insurance, and life insurance industry; Issuance of health, dental, and life
`insurance; Medical insurance case and utilization review and insurance claims adjustment services for healthcare purchasers and payors and
`providers and Medicare beneficiaries; Social security and Medicare claims administration and consulting services rendered to individuals;
`Providing information about healthcare insurance plans
`
`Use in Commerce: The applicant is using the mark in commerce on or in connection with the identified goods/services. The applicant attaches, or
`will later submit, one specimen as a JPG/PDF image file showing the mark as used in commerce on or in connection with any item in the class of
`listed goods/services, regardless of whether the mark itself is in the standard character format or is a stylized or design mark. The specimen image
`file may be in color, and the image must be in color if color is being claimed as a feature of the mark.
`
`In International Class 036, the mark was first used by the applicant or the applicant's related company or licensee predecessor in interest at least
`as early as 02/15/2015, and first used in commerce at least as early as 02/15/2015, and is now in use in such commerce. The applicant is
`submitting one(or more) specimen(s) showing the mark as used in commerce on or in connection with any item in the class of listed
`goods/services, consisting of a(n) The attached Specimen A is an organizer bearing the applied-for mark being used on applicant's marketing
`materials, including to customers in order to keep all three of their health insurance cards in it, including Medicare and Medicaid cards. The
`attached Specimen B is the original business card bearing the applied-for mark being used on commerce. The attached Specimen C is the original
`letter bearing the applied-for mark being used on applicant's marketing materials, including to include with letters to customers enclosing the
`organizer depicted in Specimen A. The attached Specimen D is a poster bearing the applied-for mark being used on applicant's internal business
`materials, this serving as a reminder to employees of the applicant's business services provided to the healthcare industry. The attached Specimen
`E is the applicant's logo bearing the applied-for mark and being used in commerce..
`JPG file(s):
`Specimen File1
`Original PDF file:
`SPE0-979623164-20191007134909570723_._Specimen_A_-_Organizer.pdf
`Converted PDF file(s) (1 page)
`Specimen File1
`Original PDF file:
`
` 
`

`

`SPE0-979623164-20191007134909570723_._Specimen_B_-_Original_Business_Card.pdf
`Converted PDF file(s) (1 page)
`Specimen File1
`Original PDF file:
`SPE0-979623164-20191007134909570723_._Specimen_C_-_Letter_ENC_Organizer.pdf
`Converted PDF file(s) (1 page)
`Specimen File1
`Original PDF file:
`SPE0-979623164-20191007134909570723_._Specimen_D_-_Healthcare_Solutions_Direct_Poster.pdf
`Converted PDF file(s) (1 page)
`Specimen File1
`
`Use of the mark in another form
`The mark was first used anywhere in a different form other than that sought to be registered at least as early as 02/15/2015, and in commerce at
`least as early as 02/15/2015.
`
`Miscellaneous Statement
`The mark was first used anywhere in a different form other than that sought to be registered at least as early as February 15, 2015, and in
`commerce at least as early as February 15, 2015. That form was: Medicare is As Simple As 1-2-3. The mark is associated with TEAS PLUS
`Application, Registration Number 88644584.
`
`Original PDF file:
`MIS-979623164-20191005034543043541_._hcare_Solutions_Direct_Original_Front_and_Back_Business_Card.pdf
`Converted PDF file(s) (1 page)
`Miscellaneous File1
`
`For informational purposes only, applicant's website address is: https://www.medicaremedigap.com/
`The applicant hereby appoints DOMENICK LAZARA. DOMENICK LAZARA of DOM LAW, PA, is a member of the XX bar, admitted to the
`bar in XXXX, bar membership no. XXX, is located at
`      1814 NORTH 15TH STREET
`      TAMPA, Florida 33605
`      United States
`      813-606-5036(phone)
`      813-606-5336(fax)
`      DOM@DOMLAW.COM (authorized).
`
`DOMENICK LAZARA submitted the following statement: The attorney of record is an active member in good standing of the bar of the highest
`court of a U.S. state, the District of Columbia, or any U.S. Commonwealth or territory.
`
`The applicant's current Correspondence Information:
`      DOMENICK LAZARA
`      DOM LAW, PA
`      1814 NORTH 15TH STREET
`      TAMPA, Florida 33605
`      813-606-5036(phone)
`      813-606-5336(fax)
`      DOM@DOMLAW.COM (authorized).
`
`Email Authorization: I authorize the USPTO to send email correspondence concerning the application to the applicant or the applicant's
`attorney, or the applicant's domestic representative at the email address provided in this application. I understand that a valid email address must
`be maintained and that the applicant or the applicant's attorney must file the relevant subsequent application-related submissions via the
`Trademark Electronic Application System (TEAS). Failure to do so will result in the loss of TEAS Plus status and a requirement to submit an
`additional processing fee of $125 per international class of goods/services.
`
`A fee payment in the amount of $225 has been submitted with the application, representing payment for 1 class(es).
`
`Declaration
`
`

`

`Basis:
`If the applicant is filing the application based on use in commerce under 15 U.S.C. § 1051(a):
`
`The signatory believes that the applicant is the owner of the trademark/service mark sought to be registered;
`The mark is in use in commerce on or in connection with the goods/services in the application;
`The specimen(s) shows the mark as used on or in connection with the goods/services in the application; and
`To the best of the signatory's knowledge and belief, the facts recited in the application are accurate.
`
`AND/OR
`If the applicant is filing the application based on an intent to use the mark in commerce under 15 U.S.C. § 1051(b), § 1126(d),
`and/or § 1126(e):
`
`The signatory believes that the applicant is entitled to use the mark in commerce;
`The applicant has a bona fide intention to use the mark in commerce on or in connection with the goods/services in the
`application; and
`To the best of the signatory's knowledge and belief, the facts recited in the application are accurate.
`
`To the best of the signatory's knowledge and belief, no other persons, except, if applicable, concurrent users, have the right to use the
`mark in commerce, either in the identical form or in such near resemblance as to be likely, when used on or in connection with the
`goods/services of such other persons, to cause confusion or mistake, or to deceive.
`
`To the best of the signatory's knowledge, information, and belief, formed after an inquiry reasonable under the circumstances, the
`allegations and other factual contentions made above have evidentiary support.
`
`The signatory being warned that willful false statements and the like are punishable by fine or imprisonment, or both, under 18 U.S.C. §
`1001, and that such willful false statements and the like may jeopardize the validity of the application or submission or any registration
`resulting therefrom, declares that all statements made of his/her own knowledge are true and all statements made on information and
`belief are believed to be true.
`Declaration Signature
`
`Signature: /DOMENICK G. LAZZARA/   Date: 10/07/2019
`Signatory's Name: DOMENICK G. LAZZARA, OBO HEALTHCARE SOLUTIONS DIRECT, LLC
`Signatory's Position: ATTORNEY OF RECORD, FLA. BAR NO. 0103071
`Signatory's Phone Number: 813-606-5036
`Payment Sale Number: 88644617
`Payment Accounting Date: 10/07/2019
`
`Serial Number: 88644617
`Internet Transmission Date: Mon Oct 07 14:03:14 EDT 2019
`TEAS Stamp: USPTO/FTK-XX.XX.XXX.XX-20191007140314014
`362-88644617-6102fd351c6f5959b91af46421d
`deb4372a34a52f27e68adee23114a4b5bc9d6-CC
`-03120228-20191007134909570723
`
` 
`

`

`HEALTHCARE
`SOLUTIONS
`DIRECT
`SIMPLE AS 1-2-3
`
`

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`
`SOLUTIONS DIRECT
`
`Eddie Elsner
`CFO/Managing Partner
`Licensed Medicare Specialist
`
`
`
`1248 E Hillsborough Ave. Suite 226
`Tampa FL 33604
`
`8577-4004599 1216
`eddie@healthcsd.com
`
`

`

`+° Healthcare
`
`SOLUTIONS DIRECT
`
`Customer,
`
`We want to thank you for having chosen Healthcare Solutions Direct, LLC to help you with your
`
`Medicare Supplement Plan. As an effort to make sure our customers know we are always just
`
`a phone call away and you are never alone, please accept the enclosed MEDICARE
`
`ORGANIZER as our way of saying "Thank You.” We understand Medicare can seem confusing
`
`and overwhelming, however always keep in mind that Original Medicare Is as Simple as 1I 2I
`
`3. We are the first in the industry to introduce the MEDICARE ORGANIZER which will allow our
`
`customers to conveniently put all their cards in one place. If you know of others that could use
`
`our service or guidance with their Medicare needs, we would appreciate the referral. The best
`
`compliment you can give us is referring someone that could use our help with their Medicare.
`
`As an added effort we are constantly updating our website www.medicaregapplan.com to
`
`help keep you informed of any changes in the industry as well as some valuable tools and
`resources.
`
`Original Medicare Is as SIMPLE as l, 2, 3 ............
`
`1.) Medicare A&B- Your Medicare card in slot #1
`
`2.) Medicare Supplement (MEDIGAP) PLAN- Your Supplement card in slot #2
`
`3.)
`
`Part D (Drug Plan)- Your Standalone Prescription card in slot #3
`
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`If there are any questions you may have, please do not hesitate to contact us anytime toll free
`
`at 844-GAP-PLAN (427-7525).
`
`Best Wishes,
`
`Greg Gurbikian, President/CEO Healthcare Solutions Direct
`
`

`

`+° Healthcare
`
`SOLUTIONS DIRECT
`
`ALWAYS tell customers:
`
`DO MEA FAVOR; PLEASE GRAB A PEN AND A PIECE OF
`
`PAPER:
`
`’
`
`CALL US TOLL FREE: 844-GAP-PLAN (844-427-7526)
`
`1.) MEDICARE A (HOSPITAL) & B (MEDICAL)
`2.) MEDICARE SUPPLEMENT PLAN F or@
`
`Our Motto is: MEDICARE IS As SIMPLE AS 1, 2, 3 .....
`
`3.) MEDICARE PART D (DRUG PLAN)
`
`VISIT OUR WEBSITE AT WWW.MED|CAREGAPPLAN.COM
`
`—OR—
`
`

`

` 1 HEALTHCARE
`
`SOLUTIONS
`
`DIRECT
`
`SIMPLE AS 1—2—3
`
`

`

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`+' Healthcare
`
`SOLUTIONS DIRECT
`
`Eddie Elsner
`CFO/Managing Partner
`Licensed Medicare Specialist
`
`
`
`1248 E Hillsborough Ave. Suite 226
`Tampa FL 33604
`
`8577-4004599 1216
`eddie@healthcsd.com
`
`