What is a group open enrollment period?

Group open enrollment is an annual period of at least 30 days during which eligible employees and/or dependents may enroll in the health plan if they are not currently enrolled.

Can I choose my own dental or vision provider?

Kansas City Life allows dental plan members to choose from any practicing dentist. You may search for in-network dentists in your area here Dental Network Providers page. You may also choose your own vision provider, however to find in-network vision providers in your area, please visit: Vision Provider Directory.

What if I need a second opinion?

You may request a second medical opinion if you disagree with your dentist or the dental plan’s determination regarding the reasonableness or necessity of a surgical procedure. You may also request a second opinion if you feel you’re not responding satisfactorily to your current treatment plan after a reasonable lapse of time.

Will my information remain confidential?

All patient information is considered confidential, is governed by confidentiality policies and procedures, and will not be disclosed unless required by law. We may use confidential health information to process claims, perform quality audits, improve services and respond to appeals. In cases where we need additional information that is confidential, we will not release that information without your express written consent. Please click Here to read our privacy policy.

Financially, what are my responsibilities?

When you receive care from any dental/vision provider, you are responsible for any applicable copayment, deductible, and coinsurance, as well as payments for services not covered by your dental/vision plan, as explained in your policy. Your providers may request payment of copayment at the time of service.

What does "in-network" mean?

An "in-network" provider is a dental/vision provider who has agreed to supply covered services to members as a cost savings enrolled in the network. To search for dentists in your area please visit our Dental Network Providers page. To locate a vision provider, visit: Vision Provider Directory.

What does "out-of-network" mean?

An out-of-network provider is a dentist who has not contracted with the Kansas City Life Dental Alliance or an optometrist who has not contracted with Davis Vision or VSP.

What is a co-pay?

A co-pay, or co-payment, is the amount you are responsible to pay the provider directly at the time of an office visit or other treatment. Your co-payment amount for various services is listed in your Schedule of Benefits.

What is a deductible?

A deductible is the pre-determined amount you are responsible to pay out-of-pocket for covered services during the policy year before the dental plan starts paying. Only covered services apply toward the deductible.

What is coinsurance?

Coinsurance is the percentage of charges you are responsible for after you have met your deductible for the policy year. Your percentage amount can be found in your Schedule of Benefits.

What are Usual, Customary and Reasonable (UCR) fees?

The Usual fee is the fee usually charged for a given service by an individual provider to his or her private patient. The Customary fee is the range of usual fees charged by providers of similar training and experience in an area. The Reasonable fee is a fee that meets the two previous criteria or, in the opinion of the responsible medical or dental association’s review committee, is justifiable considering the special circumstances of the particular case in question.

How do I know what my deductible and coinsurance are?

Both are outlined in your Schedule of Benefits. You can also consult your employer’s benefits coordinator or Contact Us for information on deductibles and coinsurance.

Does Critical Illness have an ID card?

No, there are no ID cards issued for Critical Illness.

Does Critical Illness offer continuation?

Yes, you may continue under the same policy and Kansas City Life will bill you. If the group policy terminates, your "continued" coverage will also terminate. Please contact your employer about your eligibility for continuation and enrollment procedures.

Does Critical Illness offer portability?

No, portability is not offered for Critical illness.

Is Waiver of Premium offered on Critical Illness?

No, Waiver of premium is not offered for Critical Illness.

Coordination of Benefits

What if I (or my dependents) also have coverage through another carrier?

If you have additional coverage, it is your responsibility to provide us with this information as soon as possible so that we can coordinate benefits with the other policy. You may receive a request annually asking you to update this information.

Grievances & Appeals

What can I do if I have a grievance or do not agree with a decision on a denied dental claim?

We would recommend you contact Customer Service if you disagree with a payment decision made on a claim. If your question is not resolved to your satisfaction you may also request an appeal in writing. Mail your appeal to:

Boon Chapman
Attention: Appeals Coordinator
P.O. Box 9040
Austin, TX 78766

Eligibility

How do I change my address?

Employees should contact their employer about any changes to their eligibility record.

How do I add or terminate a dependent?

Employees should contact their employer about any changes to their eligibility record.

How can I obtain a new or additional ID card?

Click here to obtain a replacement dental / vision ID card.