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Of that total charge. an amount to be calculated by applying the following portion of the above rates is to be paid monthly to Blue Cross and Blue Shield of Texas, Inc.: HEALTH Employee Only $ 4.97 Employee and Children) $ 8.69 Employee and Spouse $12.97 Employee and Family $16.03 The remaining Health Contract Administration Charge amount as calculated by applying the remaining portion of each rate as follows, is to be held by the Employer and paid to Blue Cross and Blue Shield of Texas. Inc. within ten (10) days after the end of the Final Accounting Period as provided in Article III. Section D of this Agreement: HEALTH Employee Only _ $ .26 Employee and Children) $ .45 Employee and Spouse $ .68 Employee and Family $ ..83 These amounts are guaranteed for the indicated Contract Year and are included in the Health Contract Underwritten Premium. ITEM VII The SPECIFIC HEALTH CONTRACT STOP LOSS PREMIUM for the Contract Year shall be calculated monthly by multiplying, respectively. the number of Health Certificates exposed for a particular month by the rates for the category of certificate indicated below and totaling the results thus obtained. These amounts are guaranteed for the indicated Contract Year and are included in the Health Contract Underwritten Premium. Employee Only $ 6.13 Employee and Children) $10.71 Employee and Spouse $15.99 Employee and Family $19.75 ITEM VIII The MINIMUM BALANCE to be maintained by the Employer in the Employer's Account at The Bank is $10,672 for November 1. 1987 through October 31 1988. i:. �:.. ��.�,.. 7?i3 s,'v z., Q'(d /A�y t {,..• r t ,tiLt.,;i.