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1988
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1988
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9/2/2015 12:47:04 PM
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CITY CLERK
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28- <br />Mr. Gene Anderson <br />September 3, 1987 <br />Page two <br />C. If Item IV (a) or IV (b) of the Exhibit is indicated <br />"applied for," Blue Cross and Blue Shield of Texas <br />Inc. will furnish the Employer a Specific Health <br />-Stop Loss Benefit report after the end of each month <br />occurring within an Accounting Period in which <br />Specific Health Stop Loss Benefits were paid. The <br />report will detail for the month cumulative Specific <br />Health Stop Loss Benefits, Cumulative Draft <br />Authority, Health Benefit Checks and all other data <br />required for settlement, as provided herein. Within <br />10 days after issuance of such report, Blue Cross <br />and Blue Shield of Texas, Inc. will settle with the <br />Employer for_ any Specific Health Stop Loss Benefits <br />involved. Based on the -report, the following <br />applies: <br />1. If the report reflects that the Cumulative Draft <br />Authority was exceeded, the amount of Specific <br />Health Stop Loss Benefits paid during the month <br />will be compared to that excess amount. If the <br />Specific Health Stop Loss Benefit amount is <br />greater than said excess amount, an amount equal <br />to the difference between those two amounts will <br />be paid to the Employer and the Suspense Account <br />will be reduced by an amount equal to said <br />excess amount. If the Specific Health Stop Loss <br />Benefit amount is less than said excess amount, <br />the Suspense Account will be reduced by an <br />amount equal to the Specific Health Stop Loss <br />Benefit amount. <br />2. If the report reflects that the Cumulative Draft <br />Authority was not exceeded for the month, an <br />amount equal to the amount of Specific Health <br />Stop Loss Benefits paid during the month will be <br />paid to the Employer. <br />3. To the extent that amounts are paid to the <br />Employer by Blue Cross and Blue Shield of Texas, <br />Inc. as a result of any monthly Specific Health <br />Stop Loss Benefit settlement, as described in <br />paragraphs 1 or 2 above, available Draft <br />Authority will be restored by those amounts. <br />i <br />
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