Trademark/Service Mark Application, Principal Register
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
The mark consists of standard characters, without claim to any particular font style, size, or color.
REGISTER
Principal
APPLICANT INFORMATION
*OWNER OF MARK
INA Corporation
*STREET
436 Walnut Street
*CITY
Philadelphia
*STATE
(Required for U.S. applicants)
Pennsylvania
*COUNTRY
United States
*ZIP/POSTAL CODE
(Required for U.S. and certain international addresses)
19106
LEGAL ENTITY INFORMATION
TYPE
corporation
STATE/COUNTRY OF INCORPORATION
Pennsylvania
GOODS AND/OR SERVICES AND BASIS INFORMATION
INTERNATIONAL CLASS
036
*IDENTIFICATION
Insurance services, namely, risk control and risk management services, and claims administration and claims processing services, all in the
field of workers compensation insurance; Pharmacy benefit management services; medical benefit management services; administration of pharmacy benefit plans; organization and administration of
networks of preferred healthcare providers; claims administration services in the field of health insurance; insurance administration in the field of health care; medical insurance case and
utilization review and insurance claims adjustment services; administration of managed health care plans; insurance services, namely, administration of healthcare benefit insurance plans;
organization and administration of networks of preferred healthcare provider; medical and pharmacy benefit management services, namely, tracking, monitoring, assessing and analyzing information and
statistics regarding patient prescription drug use, medical care, and healthcare habits, to identify potential cost savings and clinical benefits; Insurance claims processing, insurance
administration and insurance claims adjudication; insurance claims processing in the field of pharmacy claims; Organizing preferred provider programs in the field of workers compensation
copy of Applicant's brochure displaying its mark in direct connection with its risk control and risk management services
services
INTERNATIONAL CLASS
035
*IDENTIFICATION
medical cost containment services to improve health, affordability and patient experience; health benefit plan management services of others
in the nature of cost management for the health benefit plans of others; Health related insurance services, namely, cost management of health insurance plans, consumer driven health care plans, and
health reimbursement arrangements that mutually benefit employees, employers, and the greater society based on dynamic pricing and risk-management analysis, and health benefit plan cost management
services; Health care utilization and review services; Business information services, namely, providing health claim audit information obtained pursuant to medical bill review and insurance premium
audits; Cost management for the healthcare, clinical and prescription drug benefit plans of others; medical cost management; business services, namely, prescription drug formulary cost management
services; consulting services regarding healthcare and pharmacy costs; healthcare utilization review services; organization and administration of networks of preferred healthcare providers, namely,
arranging of managed care contractual services in the fields of health and medical services; cost management for the health care benefit plans of others; health care cost management services and
healthcare utilization and review services; business risk management; interactive record-keeping services for use in risk management and regulatory compliance by insurers; providing statistical
evaluation of insurance claims performance measures for others; financial record-keeping for insurance risk management; business management consulting services, namely, insurance review in the nature
of insurance claims auditing services and tracking and monitoring insurance compliance for business purposes; insurance claims auditing services; business risk assessment and business risk management
consultation, namely, providing advice regarding safety and loss programs that identify, mitigate, and prevent risk
copy of Applicant's brochure displaying its mark in direct connection with its medical cost containment services
ATTORNEY INFORMATION
NAME
Matthew A. Homyk
ATTORNEY DOCKET NUMBER
125715-00745
ATTORNEY BAR MEMBERSHIP NUMBER
XXX
YEAR OF ADMISSION
XXXX
U.S. STATE/ COMMONWEALTH/ TERRITORY
XX
FIRM NAME
Blank Rome LLP
STREET
One Logan Square
CITY
Philadelphia
STATE
Pennsylvania
COUNTRY
United States
ZIP/POSTAL CODE
19103
PHONE
+Exception caught when try to retrieve message-
FAX
2158325360
EMAIL ADDRESS
mhomyk@blankrome.com
AUTHORIZED TO COMMUNICATE VIA EMAIL
Yes
OTHER APPOINTED ATTORNEY
Timothy D. Pecsenye, David M. Perry, Bruce D. George, Lisa Casey Spaniel, Megan E. Spitz, Zachary A. Aria, John Sullivan, Bradford Craig,
Shaun J. Bockert, Thomas H. Kelly, Samar Aryani-Sabet, Blake Fink
CORRESPONDENCE INFORMATION
NAME
Matthew A. Homyk
FIRM NAME
Blank Rome LLP
STREET
One Logan Square
CITY
Philadelphia
STATE
Pennsylvania
COUNTRY
United States
ZIP/POSTAL CODE
19103
PHONE
+Exception caught when try to retrieve message-
FAX
2158325360
*EMAIL ADDRESS
mhomyk@blankrome.com
*AUTHORIZED TO COMMUNICATE VIA EMAIL
Yes
FEE INFORMATION
APPLICATION FILING OPTION
TEAS RF
NUMBER OF CLASSES
2
APPLICATION FOR REGISTRATION PER CLASS
275
*TOTAL FEE DUE
550
*TOTAL FEE PAID
550
SIGNATURE INFORMATION
SIGNATURE
/matthew homyk/
SIGNATORY'S NAME
Matthew A. Homyk
SIGNATORY'S POSITION
Attorney of record, Pennsylvania bar member
DATE SIGNED
10/28/2019
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
Serial Number:88670483
Filing Date:10/28/2019
To the Commissioner for Trademarks:
MARK: ESIS MEDICAL IMPACT (Standard Characters, see mark)
The literal element of the mark consists of ESIS MEDICAL IMPACT. The mark consists of standard characters, without claim to any particular font style, size, or color.
The applicant, INA Corporation, a corporation of Pennsylvania, having an address of
436 Walnut Street
Philadelphia, Pennsylvania 19106
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:
International Class 036: Insurance services, namely, risk control and risk management services, and claims administration and claims processing services, all in the field of workers
compensation insurance; Pharmacy benefit management services; medical benefit management services; administration of pharmacy benefit plans; organization and administration of networks of preferred
healthcare providers; claims administration services in the field of health insurance; insurance administration in the field of health care; medical insurance case and utilization review and
insurance claims adjustment services; administration of managed health care plans; insurance services, namely, administration of healthcare benefit insurance plans; organization and administration of
networks of preferred healthcare provider; medical and pharmacy benefit management services, namely, tracking, monitoring, assessing and analyzing information and statistics regarding patient
prescription drug use, medical care, and healthcare habits, to identify potential cost savings and clinical benefits; Insurance claims processing, insurance administration and insurance claims
adjudication; insurance claims processing in the field of pharmacy claims; Organizing preferred provider programs in the field of workers compensation
In International Class 036, the mark was first used by the applicant or the applicant's related company or licensee or predecessor in interest at least as early as 05/23/2019, and first used in
commerce at least as early as 05/23/2019, 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) copy of Applicant's brochure displaying its mark in direct connection with its risk control and risk management services services.
International Class 035: medical cost containment services to improve health, affordability and patient experience; health benefit plan management services of others in the nature of cost
management for the health benefit plans of others; Health related insurance services, namely, cost management of health insurance plans, consumer driven health care plans, and health reimbursement
arrangements that mutually benefit employees, employers, and the greater society based on dynamic pricing and risk-management analysis, and health benefit plan cost management services; Health care
utilization and review services; Business information services, namely, providing health claim audit information obtained pursuant to medical bill review and insurance premium audits; Cost management
for the healthcare, clinical and prescription drug benefit plans of others; medical cost management; business services, namely, prescription drug formulary cost management services; consulting
services regarding healthcare and pharmacy costs; healthcare utilization review services; organization and administration of networks of preferred healthcare providers, namely, arranging of managed
care contractual services in the fields of health and medical services; cost management for the health care benefit plans of others; health care cost management services and healthcare utilization
and review services; business risk management; interactive record-keeping services for use in risk management and regulatory compliance by insurers; providing statistical evaluation of insurance
claims performance measures for others; financial record-keeping for insurance risk management; business management consulting services, namely, insurance review in the nature of insurance claims
auditing services and tracking and monitoring insurance compliance for business purposes; insurance claims auditing services; business risk assessment and business risk management consultation,
namely, providing advice regarding safety and loss programs that identify, mitigate, and prevent risk
In International Class 035, the mark was first used by the applicant or the applicant's related company or licensee or predecessor in interest at least as early as 05/23/2019, and first used in
commerce at least as early as 05/23/2019, 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) copy of Applicant's brochure displaying its mark in direct connection with its medical cost containment services.
The applicant hereby appoints Matthew A. Homyk. Other appointed attorneys are Timothy D. Pecsenye, David M. Perry, Bruce D. George, Lisa Casey Spaniel, Megan E. Spitz, Zachary A. Aria, John Sullivan,
Bradford Craig, Shaun J. Bockert, Thomas H. Kelly, Samar Aryani-Sabet, Blake Fink. Matthew A. Homyk of Blank Rome LLP, is a member of the XX bar, admitted to the bar in XXXX, bar membership no.
XXX, and the attorney(s) is located at
One Logan Square
Philadelphia, Pennsylvania 19103
United States
+Exception caught when try to retrieve message-(phone)
2158325360(fax)
mhomyk@blankrome.com (authorized).
The attorney docket/reference number is 125715-00745.
Matthew A. Homyk 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:
Matthew A. Homyk
Blank Rome LLP
One Logan Square
Philadelphia, Pennsylvania 19103
+Exception caught when try to retrieve message-(phone)
2158325360(fax)
mhomyk@blankrome.com (authorized).
Email Authorization: I authorize the USPTO to send email correspondence concerning the application to the applicant, 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 Reduced Fee 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 $550 has been submitted with the application, representing payment for 2 class(es).
Declaration
Declaration Signature
Signature: /matthew homyk/ Date: 10/28/2019
Signatory's Name: Matthew A. Homyk
Signatory's Position: Attorney of record, Pennsylvania bar member
Payment Sale Number: 88670483
Payment Accounting Date: 10/28/2019
Serial Number: 88670483
Internet Transmission Date: Mon Oct 28 09:15:28 EDT 2019
TEAS Stamp: USPTO/BAS-XX.XX.XXX.XX-20191028091528110
650-88670483-70028c7855ad5965b13a511df1e
fd5a711981f82107c66e225e0de591e5527307d-
CC-15266251-20191028085001412219
