Fill and Sign the Health Benefit Plan Form

AGREEMENT AGREEMENT made this _____ day of ___________ , 2000 by and between Blue Cross and Blue Shield Association, a not-for-profit corporation, authorized and existing under the laws of the State of Illinois (hereinafter called the "Association") and Blue Cross and Blue Shield of Missouri, a corporation, authorized and existing under the laws of the State of Missouri (hereinafter called the "Plan"). WHEREAS, Title 5, Chapter 89 of the United States Code contemplates the provision of health benefit sunder one Government-wide Service Benefit Plan, and WHEREAS, the Plan is engaged in providing health care benefits to subscribers. NOW, THEREFORE in consideration of the execution of this agreement by Blue Cross and Blue Shield Plans, other than the undersigned, and in further consideration of the undertakings set forth in this Exhibit, IT IS AGREED AS FOLLOWS: ARTICLE I The Association is hereby authorized and directed by the undersigned Plan to execute on behalf of the Plan the necessary documents, including any amendments thereof, with the United States Office of Personnel Management (hereinafter called "Agency") to furnish health benefits through the undersigned Plan and other similar Plans as provided by the Government-wide Service Benefit Plan, to those employees and annuitants, including their dependents, if any, enrolled under the Contract between the Association and the Agency. ARTICLE II In accordance with the authority herein granted, the Association is authorized to receive, on behalf of the undersigned Plan, subscription charges paid by the Agency in accordance with the terms of the contract. ARTICLE III The mutual obligations undertaken by the Association and the Plan under this agreement shall be a matter of separate agreement between the parties of this agreement. ARTICLE IV The Association may delegate its authority under this agreement, but said delegations shall not relieve the Association of its obligations under this agreement. ARTICLE V This agreement may be canceled by either party giving to the other party written notice at least 120 days prior to the last day of the then current contract term of the Contract between the Agency and the Association. ARTICLE VI This agreement supersedes any prior agreement authorizing the Blue Cross and Blue Shield Association to act for the Plan in connection with furnishing benefits under the Government-wide Service Benefit Plan. IN WITNESS WHEREOF, the parties hereto have executed this agreement the day and year aforesaid: BLUE CROSS AND BLUE SHIELD BLUE CROSS AND BLUE SHIELD OF ASSOCIATION MISSOURI By By (Typed or Printed) Name Name (Signature) (Signature) Title Senior Vice President Title Federal Employee Program Date Date