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In consideration of the payment of Premiums when due and subject to all of the terms of this Agreement, <br />Blue Cross Blue Shield of Florida, Inc, hereby agrees to provide each enrollee of Indian River County <br />BOCC. The benefits of this Agreement as set forth in the Evidence of Coverage beginning on each <br />enrollee's effective date. <br />The Group has selected the following plan and premium: <br />Advanced/Platinum PPO fv/DHV $337.99 <br />The Group's Agreement is effective as of 10/01/2025 <br />IN WITNESS WHEREOF, the parties have executed this Agreement as of dates listed below. <br />Blue Cross Blue Shield of Florida, Inc. <br />(DBA Florida Blue) <br />(Signature) <br />Indian River County BOCC #90000 <br />0 <br />OUI <br />Name: Andrea Davis Name: Joseph E. Flescher <br />(Please Print or Type) (Please Print or Type) <br />Title: Vice President, Medicare Product Grwmh & Ups. <br />9-4-2025 <br />Date: <br />Date: September 2, 2025 <br />12 <br />APPROVED AS TO FORM <br />AND S ICI'ENCY <br />BY <br />C�GA <br />CHRtZTOJHER A, HICKS <br />ASSIST T C LINTY ATTORNEY <br />Attest: Ryan L. Butler, Cleric of <br />Circuit Court and Comptroller <br />