Document:

Cash Balance Pension Plan

 Exhibit 10(n) 
 Kansas City Life Insurance 
 Company Cash Balance Pension 

Plan 
 (As Amended and Restated Effective
as of January 1, 2001 or Such Other Dates as are Set Forth Herein or Required By Law) 

 CONTENTS 
  

					
	 Article 1. The Plan
	 	 	6	  
		
	 1.1 Establishment and Amendment of the Plan
	 	 	6	  
		
	 1.2 Purpose of Plan and Trust
	 	 	6	  
		
	 1.3 Applicability of Plan
	 	 	7	  
		
	 Article 2. Definitions and Interpretation
	 	 	8	  
		
	 2.1 Definitions
	 	 	8	  
		
	 2.2 Gender and Number
	 	 	17	  
		
	 2.3 Invalidity or Illegality
	 	 	17	  
		
	 2.4 No Employment Rights
	 	 	18	  
		
	 2.5 Applicable Law
	 	 	18	  
		
	 2.6 Requirement to be in “Written Form”
	 	 	18	  
		
	 Article 3. Determination of Hour of Service, Break in Service, Vesting, Service, and Benefit Service
	 	 	19	  
		
	 3.1 Hour of Service
	 	 	19	  
		
	 3.2 Break in Service
	 	 	20	  
		
	 3.3 Vesting Service
	 	 	20	  
		
	 3.4 Benefit Service
	 	 	21	  
		
	 3.5 Special Provisions for Participants Who Enter the Armed Forces
	 	 	21	  
		
	 3.6 Leased Employees
	 	 	22	  
		
	 Article 4. Eligibility and Participation
	 	 	23	  
		
	 4.1 Date of Participation
	 	 	23	  
		
	 4.2 Reentry Into Plan Following a Break in Service
	 	 	23	  
		
	 4.3 Duration
	 	 	23	  
		
	 Article 5. Accrued Benefits and Vesting
	 	 	24	  
		
	 5.1 Accrued Benefits
	 	 	24	  
		
	 5.2 Vesting
	 	 	28	  
		
	 Article 6. Benefits
	 	 	31	  
		
	 6.1 Normal Retirement Benefits
	 	 	31	  
		
	 6.2 Early Retirement Benefits
	 	 	31	  
		
	 6.3 Disability Retirement Benefits
	 	 	32	  
		
	 6.4 Deferred Vested Retirement Benefits
	 	 	33	  
		
	 6.5 Preretirement Survivor Annuity Benefits
	 	 	33	  
		
	 6.6 Other Death Benefits
	 	 	35	  

  

					
	 6.7 Qualified Joint and Survivor Annuity
	 	 	35	  
		
	 6.8 Explanation Relating to Survivor Annuities
	 	 	37	  
		
	 6.9 Straight Life Annuity
	 	 	37	  
		
	 6.10 Optional Methods of Payment
	 	 	38	  
		
	 6.11 Maximum Annual Benefits
	 	 	39	  
		
	 6.12 Payment of Small Amounts
	 	 	40	  
		
	 6.13 No Rollover or Trust-to-Trust Transfer to the Plan
	 	 	41	  
		
	 6.14 Direct Rollover from the Plan
	 	 	41	  
		
	 Article 7. Commencement of Payments and Duration
	 	 	43	  
		
	 7.1 Commencement
	 	 	43	  
		
	 7.2 Employee Status
	 	 	44	  
		
	 7.3 Suspension of Benefits
	 	 	44	  
		
	 7.4 Suspension of Benefits Notice and Procedures
	 	 	45	  
		
	 7.5 Time Limits for Payment of Benefits
	 	 	45	  
		
	 7.6 Withholding Taxes
	 	 	46	  
		
	 Article 8. Funding
	 	 	47	  
		
	 8.1 Company Contributions
	 	 	47	  
		
	 8.2 Nonreversion
	 	 	47	  
		
	 Article 9. Allocation of Fiduciary Responsibility
	 	 	48	  
		
	 9.1 Fiduciaries
	 	 	48	  
		
	 9.2 Administrative Committee
	 	 	48	  
		
	 9.3 Trustees
	 	 	48	  
		
	 9.4 Fiduciary Responsibility
	 	 	48	  
		
	 Article 10. The Trustees
	 	 	49	  
		
	 10.1 Number of Trustees
	 	 	49	  
		
	 10.2 Trust Funds
	 	 	49	  
		
	 10.3. Investment of Funds
	 	 	49	  
		
	 10.4 Prior Approval of Investments
	 	 	50	  
		
	 10.5 Disbursements
	 	 	50	  
		
	 10.6 No Independent Determination
	 	 	51	  
		
	 10.7 Indemnification Insurance
	 	 	51	  
		
	 10.8 Annual Account
	 	 	51	  
		
	 10.9 Valuation of Assets
	 	 	51	  
		
	 10.10 Remuneration
	 	 	51	  

  

					
	 10.11 Removal, Resignation, and Replacement of Trustees
	 	 	51	  
		
	 10.12 Trustees’ Rules
	 	 	52	  
		
	 Article 11. Payments to Trust
	 	 	53	  
		
	 11.1 Company Contributions
	 	 	53	  
		
	 Article 12. Payment of Pensions
	 	 	54	  
		
	 12.1 Payment to Members
	 	 	54	  
		
	 12.2 Direction by Administrative Committee
	 	 	54	  
		
	 Article 13. Inalienability of Benefits and Incompetency
	 	 	55	  
		
	 13.1 Prohibition of Alienation
	 	 	55	  
		
	 13.2 Incompetency
	 	 	55	  
		
	 Article 14. Administrative Committee
	 	 	56	  
		
	 14.1 Composition and Responsibility
	 	 	56	  
		
	 14.2 Powers
	 	 	56	  
		
	 14.3 Meetings
	 	 	56	  
		
	 14.4 Quorum
	 	 	56	  
		
	 14.5 Compensation and Bonding
	 	 	56	  
		
	 14.6 Rules and Regulations
	 	 	56	  
		
	 14.7 Interpretation
	 	 	56	  
		
	 14.8 Effect of a Mistake
	 	 	56	  
		
	 14.9 Adjudication
	 	 	57	  
		
	 14.10 Reports to Executive Committee
	 	 	57	  
		
	 14.11 Resignation and Replacement
	 	 	57	  
		
	 14.12 Maintenance of Funding Standard Account
	 	 	57	  
		
	 Article 15. Amendment and Merger, Consolidation, or Transfer
	 	 	58	  
		
	 15.1 Amendment
	 	 	58	  
		
	 15.2 Merger, Consolidation, or Transfer
	 	 	58	  
		
	 Article 16. Termination of Plan
	 	 	59	  
		
	 16.1 Discontinuance of Plan
	 	 	59	  
		
	 16.2 Distribution on Discontinuance
	 	 	59	  
		
	 16.3 Distribution Medium
	 	 	59	  
		
	 16.4 Reversion to Company
	 	 	59	  
		
	 Article 17. Temporary Restrictions on Benefits
	 	 	60	  
		
	 17.1 Temporary Limitation on Benefits of Restricted Members
	 	 	60	  
		
	 Article 18. Top-Heavy Provisions
	 	 	62	  

  

					
	 18.1 Application of Top-Heavy Provisions
	  	 	62	  
		
	 18.2 Definitions
	  	 	62	  
		
	 18.3 Vesting Requirements
	  	 	64	  
		
	 18.4 Minimum Benefit
	  	 	64	  
		
	 18.5 Collective Bargaining Agreements
	  	 	65	  
		
	 Appendix A. Prior Plan Benefits
	  	 	67	  
		
	 A.1 Prior Plan Accrued Benefit
	  	 	67	  
		
	 A.2 Prior Plan Early Retirement Benefit
	  	 	69	  
		
	 A.3 Prior Plan Credit for Disability
	  	 	71	  
		
	 A.4 Prior Plan Consumer Price Index Benefits
	  	 	72	  
		
	 A.5 Prior Plan Normal Form of Benefit for Certain Old American Participants
	  	 	73	  
		
	 A.6 Definitions and Construction
	  	 	73	  

 Article 1. The Plan 
 1.1 Establishment and Amendment of the Plan 
 In order to increase the retirement benefits
to its salaried employees, Kansas City Life Insurance Company, by Resolution of its Board of Directors on October 4, 1951, discontinued its Employee Retirement Annuity Plan adopted on January 1, 1939, and in lieu thereof established the
Kansas City Life Employees Pension Trust. 
 Since the discontinuance of said Retirement Annuity Plan on January 1, 1951, no further
certificates under that Plan have been issued. Annuities made available under said Annuity Plan were purchased with contributions made by both the Company and the respective employee. The benefits payable from those annuities, to the extent paid for
by contributions of the Company, shall be taken into consideration with and included in the regular benefits payable pursuant to this Plan, and the maximum authorized herein shall prevail. 
 For any employee of Kansas City Life Insurance Company who becomes eligible for retirement on or after January 1, 1970, to the extent his said annuity was purchased with his contributions, he may
surrender said annuity and said contributions may be refunded to him prior to his retirement at his option with interest accumulated as provided for in paragraph (a) of Article 7 herein. In the alternative, additional retirement benefits shall
be available to the respective employee as if voluntary contributions had been made pursuant to Article 7 herein. 
 This Agreement has been
made, and this Plan and Trust created for the exclusive benefit of the participating employees and their beneficiaries. The terms of this Plan and Trust are intended to comply with the present provisions of sections 401(a) and 501(a) of the Internal
Revenue Code of 1986 as they have been amended from time to time, all other applicable law, the Treasury Department Regulations in connection therewith, in order that the Plan and Trust may qualify for tax exemption. Under no circumstances shall any
part of the principal or income of the Plan and Trust be used for, or revert to, the Company, or be used for, or diverted to, any purposes other than for the exclusive benefit of the employees and their beneficiaries. This Plan and Trust shall not
be construed, however, as giving any employee, or any other person, any right, legal or equitable, as against the Company, the Trustees, or, the principal or income of the Trust, except as specifically provided for herein, nor shall it be construed
as giving any employee the right to remain in the Company’s employment. 
 1.2 Purpose of Plan and Trust 

This Plan and Trust is intended to provide retirement benefits for Employees who become vested Participants under the Plan. The Plan is intended to meet
the requirements of Code section 401(a), and the Trust is intended to qualify under Code section 501(a). Notwithstanding any contrary Plan or Trust provision, if any modification of the Code (or regulations or rulings thereunder) requires that a
conforming Plan or Trust amendment be adopted as of a stated effective date in order for this Plan and Trust to continue as a qualified plan and trust, this Plan and Trust will be operated in accordance with such requirements until the date when a
conforming Plan amendment is adopted. 

  
 6 

 1.3 Applicability of Plan 
 The provisions of this Plan as set forth in this amendment and restatement are applicable only to the Employees of an Employer in current employment on or after January 1, 1998, except as
specifically provided herein. Except as so provided, any person who was covered under the Plan as in effect on December 31, 1997 and whose Vesting Service terminated under the Plan prior to January 1, 1998 and who was entitled to benefits
under the provisions of the Plan shall continue to be entitled to the same amount of benefits without change under this Plan. 

  
 7 

 Article 2. Definitions and Interpretation 
 2.1 Definitions 
 Whenever used in the Plan, the following words and phrases shall have the
respective meanings stated below unless a different meaning is plainly required by the context, and where the defined meaning is intended, the term is capitalized. 
  

	(a)	“Accrued Benefit” means the Member’s benefit, determined under section 5.1, payable on the Member’s Normal Retirement Date or (if the Member
has already attained Normal Retirement Age) the first day of the month following the month in which the Accrued Benefit is determined. 

  

	(b)	“Act” means the Employee Retirement Income Security Act of 1974, as amended. 

 

	(c)	“Actuarial Equivalent” means a benefit having the same value as the benefit which it replaces. 

 

	 	(1)	Assumptions/Factors. In cases where specific assumptions or factors are identified by the Plan as being applicable to a particular benefit or situation (for
example, in section 6.5(b) and section 6.7(d)), the specified assumptions or factors shall be used. In other cases, the determination shall be made based upon the Applicable Mortality Table, the Applicable Interest Rate, and, where a cost-of-living
assumption is required, an assumed cost-of-living increase equal to 2.75 percent per annum. 

  

	 	(2)	Single Sums. For the purpose of determining single sum cash settlements— 

 

	 	(A)	the mortality table used shall be the Applicable Mortality Table; 

  

	 	(B)	the interest rate used shall be the Applicable Interest Rate; and 

  

	 	(C)	the Member’s benefit used shall be the Accrued Benefit payable on the Member’s Normal Retirement Date or, if the Member has reached Normal Retirement Date,
the Accrued Benefit payable on the Annuity Starting Date. 

  

	(d)	“Actuary” means a person (or a firm of which he is a member) who is qualified through membership in the Society of Actuaries or its successors, who is
an “enrolled actuary” under the Act, and who is chosen by but is independent of the Company. 

  

	(e)	“Administrative Committee” means the committee responsible for the administration of the Plan, as described in Article 14. 

  
 8 

  

	(f)	“Affiliate” means 

  

	 	(1)	any corporation other than the Company, i.e., either a subsidiary corporation or an affiliated or associated corporation of the Company, which together with the Company
is a member of a “controlled group” of corporations (as defined in section 414(b) of the Code); 

  

	 	(2)	any organization which together with the Company is under “common control” (as defined in section 414(c) of the Code); 

 

	 	(3)	any organization which together with the Company is an “affiliated service group” (as defined in section 414(m) of the Code); or 

 

	 	(4)	any other entity required to be aggregated with the Company pursuant to regulations under section 414(o) of the Code. 

 

	(g)	“Annuity Starting Date” means, in the case of benefits payable in the form of an annuity, the first day of the first period for which an amount is
received under the Plan; and in the case of a benefit payable in the form of a single sum cash payment, the date on which all events have occurred which entitle the Member to such benefit. 

 

	(h)	“Applicable Interest Rate” means the annual interest rate on 30-year Treasury securities for November of the year preceding the Plan Year during which
an Annuity Starting Date occurs, as specified by the Commissioner of the Internal Revenue Service in revenue rulings, notices or other guidance published in the Internal Revenue Bulletin. 

 

	(i)	“Applicable Mortality Table” means the prevailing commissioners’ standard table (described in Code section 807(d)(5)(A)) for purposes of Code
section 417(e), used to determine reserves for group annuity contracts issued on the date as of which present value is being determined (without regard to any other subparagraph of Code section 807(d)(5)), that is prescribed by the Commissioner of
the Internal Revenue Service in revenue rulings, notices, or other guidance published in the Internal Revenue Bulletin. 

  

	(j)	“Beneficiary” means 

  

	 	(1)	In the case of each Member who does not have a Spouse, the individual designated by the Member, in such form as the Administrative Committee may prescribe, to receive
benefits under the Plan. 

  

	 	(2)	 In the case of each Member who has a Spouse, the surviving spouse of such Member unless, in the case of an Old American Participant entitled to a
10-Year Certain and Life Annuity described in section A.5 of the Appendix hereto, the Member elects and such Spouse consents in writing to the designation of a different Beneficiary. Each married Member entitled to 10-Year Certain and Life Annuity
as described in section A.5 of said Appendix may designate a different individual as Beneficiary by completing and returning to the Administrative Committee before the Member’s Annuity Starting Date a form approved by the Administrative
Committee; provided, however, that the Member may not change his Beneficiary without the written consent of such 

  
 9 

	 	 
Member’s Spouse, unless such Spouse’s prior consent expressly permits subsequent designations by the Member without any requirement of further consent by the Spouse. The written consent
of such Spouse shall acknowledge the effect of such election and shall be witnessed by a Plan representative designated by the Administrative Committee or a notary public. 

 

	 	(3)	In the event a designation of Beneficiary is for any reason legally ineffective, distribution shall be made— 

 

	 	(A)	in the case of a Member who has a Spouse, to the surviving Spouse of such Member; and 

 

	 	(B)	 in the case of a Member who does not have a Spouse, to the individual designated by the Member to receive life insurance benefits from the
Company’s Group Insurance Plan; 

 or if none, the Member’s children in equal shares; or if none, the
Member’s parents in equal shares; or if none, the Member’s estate. 
  

	(k)	“Benefit Service” means a period of employment, as defined in section 3.4, used to determine a Member’s Pay Credit Percentage.

  

	(1)	“Board of Directors” means the board of directors of the Company. 

 

	(m)	“Break in Service” means an absence from employment, as defined in section 3.2. 

 

	(n)	“Cash Balance Account” means the notional account deemed to have been established for each Participant for the amount determined pursuant to section
5.1(c), (d), (e), and (f); and with reference to which the Projected Cash Balance Account is determined. 

  

	(o)	“Cash Balance Benefit” means that part of the Member’s Accrued Benefit which accrues in accordance with the provisions of section 5.1(b).

  

	(p)	“Code” means the Internal Revenue Code of 1986, as amended from time to time. 

 

	(q)	“Company” means Kansas City Life Insurance Company and any successor adopting the Plan. 

  
 10 

  

	(r)	“Compensation” means— 

  

	 	(1)	For all purposes of the Plan, except as otherwise specified, — 

  

	 	(A)	the fixed amounts, hourly, weekly, semi-monthly, or monthly, due and payable to the Employee by the Employer, not including any bonuses, overtime pay, pay in lieu of
vacation, pay while on layoff, severance pay, or other extraordinary payments by the Employer; including 

  

	 	(B)	any amounts contributed or deferred by the Employer on a pretax basis, at the Employee’s election, to a cafeteria plan under Code section 125 or a cash-or-deferred
arrangement under Code section 401(k) and any associated deferred compensation arrangement. 

  

	 	(2)	For purposes of applying the limits of Code section 415, as described in section 6.11, Compensation shall be defined as set forth in Code section 415, and the
regulations thereunder, which Code section 415 is hereby incorporated by reference. 

 For limitation years
beginning on and after January 1, 2001, for purposes of applying the limitations described in section 2.1(r)(2) of the Plan, Compensation paid or made available during such limitation years shall include elective amounts that are not includible
in the gross income of the Employee by reason of Code section 132(f)(4). 
  

	 	(3)	The Compensation of each Employee that may be taken into account for purposes other than section 6.11 and Article 18 shall not exceed the limits set forth in
subparagraphs (A) and (B) below; and in determining the Compensation of an Employee for purposes of these limits prior to January 1, 1997, the rules of Code section 414(q)(6) shall apply, except in applying such rules, the term
“family” shall include only the Employee’s spouse and any lineal descendants of the Employee who have not attained age 19 before the close of the Plan Year. Such family aggregation rules shall not be applicable for Plan Years
beginning on or after January 1, 1997. 

  

	 	(A)	In addition to other applicable limitations set forth in the Plan, and notwithstanding any other provision of the Plan to the contrary, for calendar years beginning on
or after January 1, 1989, but before January 1, 1994, the Compensation of each Employee that may be taken into account shall not exceed the first $200,000 of the Employee’s Compensation (as adjusted by the Secretary of the Treasury
under Code section 415(d)). 

  
 11 

  

	 	(B)	In addition to other applicable limitations set forth in the Plan, and notwithstanding any other provision of the Plan to the contrary, for Plan Years beginning on or
after January 1, 1994, the Compensation of each Employee taken into account shall not exceed the OBRA `93 annual compensation limit. The OBRA `93 annual compensation limit is $150,000, as adjusted by the Commissioner of Internal Revenue for
increases in the cost of living in accordance with Code section 401(a)(17)(B). The cost-of-living adjustment in effect for a calendar year applies to any period, not exceeding 12 months, over which Compensation is determined (determination period)
beginning in such calendar year. If a determination period consists of fewer than 12 months, the OBRA `93 annual compensation limit will be multiplied by a fraction, the numerator of which is the number of months in the determination period, and the
denominator of which is 12. 

 For Plan Years beginning on or after January 1, 1994, any reference in this
Plan to the limitation under Code section 401(a)(17) shall mean the OBRA `93 annual compensation limit set forth in this provision. 
 If Compensation under paragraph (1) for any prior determination period is taken into account in determining an Employee’s benefits accruing in the current Plan Year, the Compensation for that
prior determination period is subject to the applicable annual compensation limit in effect for that prior period. For this purpose, in determining benefits in Plan Years beginning on or after January 1, 1989, the annual compensation limit in
effect for determination periods beginning before that date is $200,000. In addition, in determining benefits in Plan Years beginning on or after January 1, 1994, the annual compensation limit in effect for determination periods beginning
before that date is $150,000. 
  

	(s)	“Disability” means a physical or mental condition that renders a Member eligible to receive benefits under the Kansas City Life Disability Plan which
was effective January 1, 1985, or the Sunset Life Long Term Disability Plan which was effective August 1, 1989. 

  

	(t)	“Early Retirement Age” means a Participant’s age (prior to age 65) when he has both attained age 55 and the sum of his age and years of employment
after his twenty-fifth birthday by the Company and Affiliates equals at least 75; provided, however, if he became a participant in the Plan prior to January 1, 1982, his Early Retirement Age shall occur on the earlier of

  

	 	(1)	the date on which he has both attained age 60 and completed at least ten years of participation in the Plan; or 

 

	 	(2)	the date on which he has both attained age 55 and completed at least 15 years of participation in the Plan. 

  
 12 

 For purposes of the preceding paragraph, a “year of employment” shall mean a
twelve consecutive month period beginning with the Participant’s date of employment, or his twenty-fifth birthday, if later, and each complete month in the final year of employment ending on his date of termination or retirement. A “year
of participation” shall mean a twelve consecutive month period beginning with the date a Participant commences participation in the Plan, and subsequent anniversaries thereof, in which the Participant completes at least 1,000 Hours of Service.

  

	(u)	“Employee” means any person employed by the Company or an Affiliate as a common law employee, and shall not include— 

 

	 	(1)	general agents, agents, or others who would be termed “independent contractors”; 

 

	 	(2)	employees who are members of a collective bargaining unit where retirement benefits were the subject of good faith bargaining unless the collective bargaining agreement
with the Employer applicable to such employee specifically provides for his coverage under the Plan; or 

  

	 	(3)	leased employees, as defined in Code section 414(n) and (o), except to the extent required by section 3.6 of the Plan. 

Persons who are not designated as “employees” in the Employer’s employment records during a particular period of time,
including persons designated as agents or independent contractors, are not considered to be an Employee during that period of time. Such a person shall not be considered to be an “Employee,” even if a determination is made by the Internal
Revenue Service, the Department of Labor, or any other government agency, court, or other tribunal, that such person is an employee for any purpose, unless and until the Employer in fact designates such person as an Employee for purposes of this
Plan. If such a designation is made, the designation shall be applied prospectively only, unless the Employer specifically provides otherwise. 
  

	(v)	“Employer” means the Company, Sunset Life Insurance Company of America, National Reserve Life Insurance Company, Armour Life Insurance Company, Old
American Insurance Company, and any other Affiliate which elects to become a party to the Plan, with the approval of the Company, by adopting the Plan for the benefit of its eligible Employees. 

 

	(w)	“Highly Compensated Employee” means— 

  

	 	(1)	effective July 1, 1987 and prior to January 1, 1997, with respect to any Plan Year prior to January 1, 1997, any Employee who at any time during the
preceding Plan Year (or such other period as the Company may elect pursuant to Treasury regulations)— 

  
 13 

  

	 	(A)	received Compensation (as defined in Code section 414(q)(7)) from the Employer and all Affiliates in excess of $75,000; 

 

	 	(B)	received Compensation (as defined in Code section 414(q)(7)) from the Employer and all Affiliates in excess of $50,000 and was in the top-paid 20 percent of Employees;

  

	 	(C)	was an officer who received Compensation (as defined in Code section 414(q)(7)) from the Employer and all Affiliates in excess of $45,000, or, if greater, one-half of
the amount in effect under Code section 415(b)(1)(A) for the preceding Plan Year; or 

  

	 	(D)	was a 5-percent owner. 

 Unless
the Company makes the “calendar year calculation election” under Treasury regulations, Highly Compensated Employee also means, with respect to any Plan Year, any Employee who, at any time during such Plan Year, met the descriptions
contained in paragraph (A), (B), or (C) and was among the top paid 100 Employees or any Employee who was a 5-percent owner. For Plan Years prior to January 1, 1997, a family member of a Highly Compensated Employee and a former employee
shall be treated as a Highly Compensated Employee to the extent required by section 4l4(q)(6) and (9) of the Code and the regulations thereunder. The dollar limits described in paragraphs (A), (B), and (C) will be adjusted to reflect
increases in the cost of living, in the manner and at the times prescribed by the Secretary of the Treasury. 
  

	 	(2)	With respect to the Plan Years beginning on and after January 1, 1997, any Employee who— 

 

	 	(A)	was a 5-percent owner at any time during the year or the preceding year; or 

 

	 	(B)	for the preceding year— 

(i) had Compensation (as defined in Code section 415(c)(3)) from the Employer and all Affiliates in excess of $80,000; and 

(ii) if the Company elects the application of this clause for such preceding year, was in the group consisting of the top 20 percent of
the Employees when ranked on the basis of Compensation paid during such preceding year. 
 The $80,000 amount is adjusted at the
same time and in the same manner as under Code section 415(d), except that the base period is the calendar quarter ending September 30, 1996. 

  
 14 

 In determining who is a Highly Compensated Employee, the following rules shall apply: 

 

	(i)	For purposes of determining the number of employees in the top-paid 20 percent, the following employees are excluded: 

 

	 	(I)	employees who have not completed six months of Service; 

  

	 	(II)	 employees who normally work less than 17 1/2 hours per week; 

  

	 	(III)	employees who normally work during not more than six months during any calendar year; 

 

	 	(IV)	employees who have not attained age 21; and 

  

	 	(V)	to the extent allowable under Treasury regulation section 1.414(q)-1T or subsequent applicable regulations, employees covered by a collective bargaining agreement
between employee representatives and the Company or an Affiliate. 

  

	(ii)	The number of officers is limited to 50 (or, if lesser, the greater of three employees or 10 percent of employees), excluding those employees described in (i)(I), (II),
(III), (IV), and (V) above. 

  

	(iii)	When no officer has compensation in excess of the dollar limit described in subparagraph (1)(C) above (as adjusted for increases in the cost of living as
prescribed by the Secretary of the Treasury), the highest paid officer is treated as highly compensated. 

  

	(iv)	A Highly Compensated Employee shall include a former employee who separated from service prior to the calendar year and who was a Highly Compensated Employee
either— 

  

	 	(I)	when the employee separated from service; or 

  

	 	(II)	at any time after the employee’s fifty-fifth birthday. 

 In lieu of determining Highly Compensated Employees under the foregoing provisions of this section 2.1(w), the Administrative Committee, in its sole discretion, may elect to use the simplified method for
determining Highly Compensated Employees as provided in Code section 414(q)(12) and/or the snapshot method for determining Highly Compensated Employees as provided in Announcement 93-130; provided that any such alternative method for determining
Highly Compensated Employees is used in compliance with any applicable Treasury regulations or other guidance issued by the Internal Revenue Service regarding the use of an alternative method for determining Highly Compensated Employees. 

  
 15 

  

	(x)	“Hour of Service” means a period of employment, as defined in section 3.1. 

 

	(y)	“Inactive Participant” means an Employee who was a Participant but who is transferred to and is in a position of employment either—

  

	 	(1)	as an Employee of an Employer where he does not meet the requirements to be a Participant; or 

 

	 	(2)	as an Employee of a nonparticipating Affiliate. 

  

	(z)	“Interest Credit” means the percentage specified by section 5.1(f). 

 

	(aa)	“Member” means a Participant, Inactive Participant, or other former Employee who is receiving or entitled to receive benefits hereunder.

  

	(bb)	“National Reserve Participant” means a Participant who was a participant in the Plan prior to January 1, 1998 and was previously an employee of
National Reserve Life Insurance Company. 

  

	(cc)	“Normal Retirement Age” means a Member’s sixty-fifth birthday. 

 

	(dd)	“Normal Retirement Date” means the first day of the calendar month immediately following the month in which the Member attains Normal Retirement Age.

  

	(ee)	“Old American Participant” means a Participant who was a participant in the Plan prior to January 1, 1998 and is an employee of Old American
Insurance Company. 

  

	(ff)	“Participant” means any Employee of an Employer who has met and continues to meet the eligibility requirements of the Plan set forth in section 4.1.

  

	(gg)	“Pay Credit Percentage” means the percentage of a Participant’s base pay, described in section 5.1(d), upon which his annual pay credit accruals
are based. 

  

	(hh)	“Plan” means the Kansas City Life Insurance Company Cash Balance Pension Plan as set forth herein and as amended from time to time, and shall include
the Trust. 

  

	(ii)	“Plan Year” means the 12-consecutive-month period ending each December 31. 

 

	(jj)	“Preretirement Survivor Annuity” means an annuity for the surviving spouse of a Member, as described in section 6.5. 

 

	(kk)	“Prior Plan” means the provisions of the Plan that were in effect on December 31, 1997. 

 

	(ll)	“Prior Plan Benefit” means the Member’s accrued benefit under the Prior Plan, as described in section A.1 of the Appendix which is attached hereto
and hereby made a part of the Plan. 

  
 16 

  

	(mm)	“Projected Cash Balance Account” means the Cash Balance Account projected to Normal Retirement Age using the Applicable Interest Rate.

  

	(nn)	“Qualified Joint and Survivor Annuity” means an annuity, which provides payments for the lifetime of the Member with a survivor annuity for the
lifetime of the Member’s Spouse, as described in section 6.7. 

  

	(oo)	“Spouse” means a person to whom a Member has been married throughout the entire one-year period ending on the Member’s Annuity Starting Date or
the Member’s death, as applicable. If a Member has married within one year prior to his Annuity Starting Date and the marriage has continued for a year or more as of the date of the Member’s death, the Member’s spouse shall be a
Spouse for purposes of the Plan. 

  

	(pp)	“Sunset Life Participant” means a Participant who was a participant in the Plan prior to January 1, 1998 and is an employee of Sunset Life
Insurance Company of America. 

  

	(qq)	“Termination of Employment” means the termination of an Employee’s employment as an Employee with the Company and all Affiliates.

  

	(rr)	“Trust” means the trust described in this document, which was established to form a part of the Plan to receive, hold, invest, and dispose of the Trust
Fund. 

  

	(ss)	“Trustee” means the corporation, individual, individuals, or combination thereof, acting as trustee under the Trust at any time of reference.

  

	(tt)	“Trust Fund” means the assets of every kind and description held under the Trust. 

 

	(uu)	“Vesting Service” means a period of employment, as defined in section 3.3. 

 2.2 Gender and Number 
 Except when otherwise indicated by the context, any masculine
terminology herein shall also include the feminine and neuter, and the definition of any term herein in the singular may also include the plural. 
 2.3 Invalidity or Illegality 
 In the event that any provision of the Plan shall be held
invalid or illegal for any reason, such determination shall not affect the remaining provisions of the Plan, but the Plan shall be construed and enforced as if such invalid or illegal provision had never been included in the Plan. 

  
 17 

 2.4 No Employment Rights 
 Participation in the Plan, as provided herein, shall not give any Employee the right to be retained in the employment of the Employer or any Affiliate, nor upon dismissal to have any rights or interests
in the Plan other than as herein provided. 
 2.5 Applicable Law 
 The Plan shall be construed in accordance with the Laws of the State of Missouri, except to the extent preempted by federal law. 
 2.6 Requirement to be in “Written Form” 
 Various notices provided by the Employer
or Administrative Committee, and various elections made by a Member are required to be in written form. To the extent permitted under IRS regulations or other guidance, these notices and elections may be conveyed through an electronic system.

  
 18 

 Article 3. Determination of Hour of Service, Break in Service, Vesting, Service, and Benefit Service

 3.1 Hour of Service 
 An
Employee’s “Hours of Service” are used to determine credit for eligibility to participate in the Plan, eligibility to receive benefits (Vesting Service), and amount of benefits (Benefit Service). Hours of Service shall be determined
as follows: 
  

	(a)	An Employee shall receive an Hour of Service for each hour for which he is paid or entitled to payment by an Employer or nonparticipating Affiliate for the performance
of duties. These hours shall be credited to the Employee for the computation period or periods in which the duties are performed. 

  

	(b)	An Employee shall receive an Hour of Service for each hour for which he is directly or indirectly paid or entitled to payment by an Employer or nonparticipating
Affiliate on account of a period of time during which no duties are performed (irrespective of whether the employment relationship has terminated) due to vacation, holidays, illness, incapacity (including disability), layoff, jury duty, military
duty, or leave of absence. These hours shall be credited to the Employee for the computation period or periods during which the nonperformance of such duties occurred. No Hour of Service shall be credited based on any payment under a plan maintained
solely to comply with applicable workers’ compensation, unemployment compensation, or disability insurance laws, or which solely reimburses an Employee for medical or medically-related expenses incurred by the Employee. No more than 501 Hours
of Service shall be credited under this subsection for any single continuous period during which the Employee did not or would not have performed duties. 

  

	(c)	An Employee shall receive an Hour of Service for each hour for which back pay, irrespective of mitigation of damages, is either awarded or agreed to by an Employer or
nonparticipating Affiliate, with no duplication of credit for hours under subsections (a) or (b) and this subsection (c). These hours shall be credited to the Employee for the computation period or periods to which the award or agreement
pertains rather than the computation period in which the award, agreement, or payment is made. With respect to periods described in subsection (b) above, crediting of back pay hours shall be subject to the limitations set forth in that
subsection. 

  

	(d)	 Solely for purposes of determining whether a one-year Break in Service under section 5.2(c)(3) has occurred, but not for purposes of determining
a Participant’s Vesting Service or Benefit Service, an Employee shall receive an Hour of Service for each hour which would have been credited to such Employee but for an approved leave of absence from employment by reason of pregnancy,
placement of a child with the Employee in connection with the adoption of such child, birth of a child, caring for a child for a period immediately following such birth or placement, or a leave of absence covered under the Family Medical Leave Act
of 1993. If the number of hours which would have been credited to the Employee cannot be determined, eight Hours of Service shall be credited per day of such absence. No more than 501 Hours of Service shall be credited

  
 19 

	 	 
under this subsection for any such absence. Hours of Service under this subsection shall be credited in the calendar year in which the absence from employment commences if the crediting is
necessary in order to prevent a one-year Break in Service or, in all other cases, such Hours of Service shall be credited in the following calendar year. 

 For purposes of crediting hours under (b) and (c) above, the Administrative Committee shall observe and follow Department of Labor regulation section 2530.200b-2(b) and (c). 

In computing an Employee’s Hours of Service on a weekly or monthly basis, when no time records are available to determine an Hour of Service
required to be credited under subsections (a), (b), and (c) above, the Employee shall be credited with 45 Hours of Service for each week, or 190 Hours of Service for each month (as applicable), for which the Employee would be required to be
credited with at least one Hour of Service under subsections (a), (b), and (c) above. 
 3.2 Break in Service 

“Break in Service” means the cessation of crediting Hours of Service when the Employee— 

 

	(a)	resigns; 

  

	(b)	is discharged; 

  

	(c)	fails to report for work within the period required under the law pertaining to veterans’ reemployment rights after he is released from military duty with the
armed forces of the United States, in which case his Break in Service shall be deemed to have occurred on the first day of his authorized leave of absence for such military duty; 

 

	(d)	is on an authorized leave of absence and fails to return to employment, in which case his Break in Service shall be deemed to have occurred on the first day of his
authorized leave of absence; or 

  

	(e)	retires or dies. 

 3.3 Vesting Service

 “Vesting Service” is used to determine a Member’s eligibility to receive benefits and to determine if an Employee’s
Vesting Service prior to a Break in Service shall be reinstated if he is reemployed. An Employee shall receive credit for Vesting Service for his period of employment with an Employer or nonparticipating Affiliate, determined as follows: 

 

	(a)	Vesting Service shall be determined in completed full Years of Service. 

  
 20 

  

	(b)	An Employee shall receive credit for one full year of Vesting Service for each Plan Year ending on or after his eighteenth birthday in which he completes 1,000 Hours of
Service. 

  

	(c)	Vesting Service shall not be deemed to have been broken— 

  

	 	(1)	by any transfer of employment of an Employee between Employers or between an Employer and nonparticipating Affiliate; or 

 

	 	(2)	if an Employee is receiving credit for Hours of Service under section 3.1. 

 

	(d)	If an Employee who has had a Break in Service on or after January 1, 1985 is subsequently reemployed by an Employer or nonparticipating Affiliate as an Employee,
his prior Vesting Service shall be reinstated on his date of reemployment, except as otherwise provided in section 5.2(c). 

3.4 Benefit Service 
 “Benefit
Service” is used to determine the credits to a Member’s Cash Balance Account. A Participant shall receive one year of Benefit Service for each Plan Year in which the Participant completes at least 1,000 Hours of Service following his
eighteenth birthday; provided, however, that the Participant shall receive a year of Benefit Service if he completes 1,000 Hours of Service in the Plan Year in which his eighteenth birthday occurs. If an Employee who has had a Break in Service on or
after January 1, 1985 is subsequently reemployed by an Employer and, pursuant to section 4.2, again becomes a Participant, his prior Benefit Service shall be reinstated on the date on which he again becomes a Participant, except as otherwise
provided in section 5.2(c). 
 In the case of any Old American Participant, Sunset Life Participant, or National Reserve Participant, Benefit
Service shall not include any service completed prior to— 
  

	(a)	January 1, 1992, in the case of any Old American Participant; 

  

	(b)	January 1, 1974, in the case of any Sunset Life Participant; or 

  

	(c)	January 1, 1982, in the case of any National Reserve Participant; 

 provided, however, that service prior to the date specified in (a), (b), or (c), whichever is applicable, shall be counted in determining the benefit accrued under the Prior Plan’s accrued benefit
formula for Participants described in section 5.1(a)(3). 
 3.5 Special Provisions for Participants Who Enter the Armed Forces

 Notwithstanding any provision of this Plan to the contrary, contributions, benefits and service credits with respect to qualified military
service will be provided in accordance with Code section 414(u). 

  
 21 

 3.6 Leased Employees 
 A person who is not an Employee of an Employer or nonparticipating Affiliate and who performs services for an Employer or a nonparticipating Affiliate pursuant to an agreement between the Employer or
nonparticipating Affiliate and a leasing organization shall be considered a “leased employee” if such person performed the services on a substantially fulltime basis for a year and the services are of a type historically performed by
employees in the business field of the Employer or nonparticipating Affiliate. Effective January 1, 1997, the determination of whether a person described in the prior sentence is a “leased employee” will be based on whether such
person’s services are performed under the primary direction or control of the recipient (in lieu of any historically performed analysis). A person who is considered a “leased employee” of an Employer or nonparticipating Affiliate
shall not be considered an Employee for purposes of participating in this Plan or receiving any benefit under this Plan subject to section 414(n)(5)(A) of the Code. A leased employee shall be excluded from this Plan regardless of whether the leased
employee participates in any plan maintained by the leasing organization. 
 However, if a leased employee participates in the Plan as a result
of subsequent employment with an Employer or nonparticipating Affiliate, the leased employee shall receive eligibility service for purposes of section 4.1 and Vesting Service, but not Benefit Service; for such employment as a leased employee.
Notwithstanding the preceding provisions of this section, a leased employee shall be treated as an Employee for purposes of applying the requirements described in section 414(n)(3) of the Code and for purposes of determining the number and identity
of Highly Compensated Employees. 

  
 22 

 Article 4. Eligibility and Participation 
 4.1 Date of Participation 
 Each Employee of an Employer on January 1, 1998, who was a
“participant” as defined in and covered by the Plan on December 31, 1997, and any other person receiving or eligible to receive any benefits under the Plan on December 31, 1997, will automatically continue to be a Member on
January 1, 1998. Each other person who is or becomes an Employee of an Employer on or after January 1, 1998 shall become a Participant in this Plan on the latest of— 

 

	(a)	January 1, 1998; 

  

	(b)	the date on which his employment with the Employer commenced; or 

  

	(c)	the first day of the month coincident with or following his twenty-first birthday, 

provided he is credited with 1,000 or more Hours of Service during the 12-consecutive-month period beginning on the date on which he
completes his first Hour of Service, or if he has not been credited with 1,000 Hours of Service within such period, beginning on the January 1 following the date on which he completes his first Hour of Service or any subsequent anniversary of
such January 1. Such 12-consecutive-month period with 1,000 or more Hours of Service credited shall be called a “year of eligibility service.” 
 4.2 Reentry Into Plan Following a Break in Service 
 A rehired Employee of an Employer who
was previously credited with a year of eligibility service with an Employer or nonparticipating Affiliate shall receive credit for that year of eligibility service. He shall become a Participant on the date of his reemployment. 

A rehired Employee of an Employer who was not previously credited with a year of eligibility service with an Employer or nonparticipating Affiliate shall
become a Participant on the date he meets the conditions of section 4.1. 
 4.3 Duration 

An eligible Employee who becomes a Participant shall continue to be a Participant or Inactive Participant until he has a Break in Service, and also shall
continue to be a Member thereafter for as long as he is entitled to receive any benefits under the Plan. If he has a Break in Service before becoming eligible to receive a benefit under the Plan, he shall cease to be a Participant or Inactive
Participant until he again becomes eligible to become a Participant in accordance with the provisions of section 4.2. 

  
 23 

 Article 5. Accrued Benefits and Vesting 
 5.1 Accrued Benefits 
  

	(a)	Determination of Amount of Accrued Benefits. 

  

	 	(1)	In the case of any Member who does not obtain an Hour of Service on or after January 1, 1998, the Accrued Benefit shall be the Member’s Prior Plan Benefit.

  

	 	(2)	In the case of any Employee on January 1, 1998— 

  

	 	(A)	who was a Participant on December 31, 1997; and 

  

	 	(B)	who on December 31, 1997 had not attained age 55 or had completed less than 15 years of Vesting Service; and 

 

	 	(C)	who obtains an Hour of Service on or after January 1, 1998, 

 the Member’s Accrued Benefit shall be a monthly amount, payable to the Member on the later of his Normal Retirement Date or (if he has already attained Normal Retirement Age) the first day of the
month following the month in which the Accrued Benefit is determined, and continuing through the last day of the calendar month which includes the date of the Member’s death. 

Such monthly amount shall be determined as follows: First, an amount shall be determined equal to the greater of— 

 

	 	(i)	the single sum Actuarial Equivalent of the Member’s Prior Plan Benefit, determined on the basis of the benefit that the Member would have been entitled to receive
on the first day of the month following the later of his Normal Retirement Age or the date on which his Vesting Service terminates; or 

  

	 	(ii)	the Member’s Cash Balance Account. 

 The amount described in the preceding sentence shall then be projected (if necessary) to the Member’s Normal Retirement Age, using the Actuarial Equivalent factors, and subsequently converted to a
life annuity using those same factors. 
  

	 	(3)	In the case of any Employee on January 1, 1998— 

  

	 	(A)	who was a Participant on December 31, 1997; and 

  

	 	(B)	who on December 31, 1997 had attained age 55 and completed 15 or more years of Vesting Service; and 

  
 24 

  

	 	(C)	who obtains an Hour of Service on or after January 1, 1998, 

 the Member’s Accrued Benefit shall be a monthly amount, payable to the Member on the later of his Normal Retirement Date or (if the Member has already attained Normal Retirement Age) the first day of
the month following the month in which the Accrued Benefit is determined, and continuing through the last day of the calendar month which includes the date of the Member’s death. 

Such monthly amount shall be determined as follows: First, an amount shall be determined equal to the greater of— 

 

	 	(i)	the Member’s Cash Balance Account; or 

  

	 	(ii)	the single sum Actuarial Equivalent of the benefit the Member would have accrued under the accrued benefit formula applicable to him under the Prior Plan on
December 31, 1997. Such benefit shall be determined on the basis of the benefit that the Member would have been entitled to receive on the first day of the month following the termination of Vesting Service; provided, however, that in no event
shall the amount determined under this sentence be less than the amount determined in the manner described in paragraph (2)(i) above. 

 The amount described in the preceding paragraph shall then be projected (if necessary) to the Member’s Normal Retirement Age, using the Actuarial Equivalent factors, and subsequently converted to a
life annuity using those same factors. 
  

	 	(4)	In the case of any Member on or after January 1, 1998 who was not a Participant on December 31, 1997, and who obtains an Hour of Service on or after
January 1, 1998, the Member’s Accrued Benefit shall be a monthly amount, payable to the Member on the later of the Member’s Normal Retirement Date or (if the Member, has already attained Normal Retirement Age) the first day of the
month following the month in which the Accrued Benefit is determined, and continuing through the last day of the calendar month which includes the date of the Member’s death, equal to the Member’s Cash Balance Benefit.

  

	 	(5)	For purposes of paragraphs (2) and (3) above, actuarial equivalence shall be determined on the basis of the Applicable Mortality Table, the Applicable
Interest Rate, and an assumed annual cost-of-living increase equal to 2.75 percent. 

  
 25 

  

	(b)	Cash Balance Benefit. Effective January 1, 1998, the monthly amount of the Member’s Cash Balance Benefit shall equal the Actuarial Equivalent of the
Member’s Projected Cash Balance Account expressed as a single-life annuity payable at Normal Retirement Date or (if the Member has already attained Normal Retirement Age) the first day of the month following the month as of which the Cash
Balance Benefit is determined. For this purpose, actuarial equivalence shall be determined on the basis of the Applicable Mortality Table and the Applicable Interest Rate. 

 

	(c)	Cash Balance Account. 

  

	 	(1)	Initial Account. The initial Cash Balance Account on January 1, 1998 of a Participant who had an accrued benefit under the Prior Plan on December 31,
1997 shall be the present value of the Participant’s Prior Plan Benefit as of December 31, 1997, determined as follows: 

  

	 	(A)	The interest rate used shall be equal to 7 percent; 

  

	 	(B)	The mortality table used shall be the Applicable Mortality Table in effect as of December 31, 1997, as specified in IRS Revenue Ruling 95-6;

  

	 	(C)	Except in the case of pre-1992 accrued benefits under the Prior Plan for Old American Participants, an annual cost-of-living increase equal to 2.75 percent shall be
assumed, based on the following criteria and deferral ages: 

  

			
	 Criteria
	  	Deferral Age
	 Members less than age 55 with 15 or more years of Vesting Service as of December 31, 1997
	  	60
		  	 
	 All other Members
	  	65
		  	 

  

	 	(D)	For purposes of (C) above, a Participant with an assumed deferral age of 60 shall be assumed to receive unreduced benefits at age 60; and 

 

	 	(E)	In the case of pre-1992 accrued benefits for Old American Participants— 

 

	 	(i)	no cost-of-living increase shall be assumed; 

  

	 	(ii)	a deferral age of 60 shall be assumed, based on the same criteria as are specified under paragraph (C); and 

 

	 	(iii)	an Old American Participant with an assumed deferral age of 60 shall be assumed to receive a benefit at age 60 equal to two-thirds of his benefit that would otherwise
be payable at age 65. 

  
 26 

 The Cash Balance Account of each other Member on the date he becomes a
Participant shall have an initial balance equal to the amount the Member would have had on that date if he had become a Participant on the first day of the month coincident with or next following the latest of— 

 

	 	(i)	his date of hire; 

  

	 	(ii)	his eighteenth birthday; and 

  

	 	(iii)	January 1, 1998. 

  

	 	(2)	Increases to Account. The initial Cash Balance Account shall— 

  

	 	(A)	increase pursuant to section 5.1(d) each calendar year that the Member is still a Participant; and 

 

	 	(B)	further increase automatically each calendar year pursuant to section 5.1(f), regardless of whether the Member is a Participant, an Inactive Participant, or a former
Participant, until benefit payments commence. 

  

	(d)	Annual Pay Credit. For calendar years beginning on or after January 1, 1998, the Participant’s Cash Balance Account described in section 5.1(c) shall
increase by an amount equal to the Participant’s Pay Credit Percentage multiplied by his Compensation for that calendar year. 

 A Participant’s Pay Credit Percentage for any year shall depend on his completed years of Benefit Service at the end of that year, and shall be determined based on the following table, adjusted (if
appropriate) pursuant to subsection (e) below: 
  

					
	 Years of
 Benefit Service
	  	Pay
Credit
Percentage	 
	 Less than 5
	  	 	3.0	% 
	 5-9
	  	 	4.0	% 
	 10-14
	  	 	5.5	% 
	 15-19
	  	 	7.0	% 
	 20-24
	  	 	9.0	% 
	 25-29
	  	 	12.0	% 
	 30 or more
	  	 	16.0	% 

  
 27 

  

	(e)	Transition Credits. For the years 1998, 1999, 2000, 2001, and 2002, the annual pay credit, if any, provided to a Participant pursuant to the table in subsection
(d) above shall be increased— 

  

	 	(1)	by 50 percent if the Participant had ten or more years of Vesting Service on December 31, 1997; or 

 

	 	(2)	by 100 percent if on December 31, 1997 the Participant had 15 or more years of Vesting Service and had attained age 45 but not age 55; 

provided, however, that the Participant’s Termination of Employment shall end his right to future transition credits, even if he is
subsequently reemployed and again becomes a Participant prior to the end of 2002. 
  

	(f)	Interest Credit. Beginning January 1, 1998 and until benefits commence, the Cash Balance Account described in subsection (c) above shall be increased
as of the end of each calendar year until benefits commence, before crediting of the Accrual Percentage for that calendar year, by an interest rate equal to— 

 

	 	(1)	7.0 percent for 1998; and 

  

	 	(2)	for years beginning after 1998, the greater of 5.5 percent or the annual interest rate on 30-year Treasury securities for November of the preceding calendar year.

 In the event benefits commence before the last day of a calendar year, the increase described in the preceding
sentence shall be prorated to reflect the portion of the calendar year preceding the date such benefits commence. 
 5.2 Vesting

 The interest of a Participant in his Accrued Benefit shall be forfeitable until such interest becomes vested under the following
provisions of this section: 
  

	(a)	Vesting Acceleration. The Participant shall become fully vested in his Accrued Benefit upon the happening of any of the following events:

  

	 	(1)	the Participant’s attainment of Normal Retirement Age; or 

  

	 	(2)	the date as of which the Company determines that the Plan has been terminated, completely or partially, but only if such partial termination is determined by the
Company to affect the Participant. 

  
 28 

  

	(b)	Vesting Schedule. Subject to the provisions of subsection (a), the vesting schedule of each Participant who obtains an Hour of Service on or after
January 1, 1998 shall vary according to the Participant’s years of Vesting Service, as follows: 

  

	 	(1)	Regular Schedule. The regular vesting schedule is— 

  

					
	 Years of
 Vesting Service
	  	Vesting
Percentage	 
	 less than 3
	  	 	0	% 
	 3
	  	 	30	% 
	 4
	  	 	40	% 
	 5
	  	 	60	% 
	 6
	  	 	80	% 
	 7 or more
	  	 	100	% 

  

	 	(2)	Transition Schedules. 

  

	 	(A)	For Participants with three years of Vesting Service under the Plan on December 31, 1997, the vesting schedule is— 

 

					
	 Years of
 Vesting Services
	  	Vesting
Percentage	 
	 3
	  	 	30	% 
	 4
	  	 	40	% 
	 5
	  	 	100	% 

  

	 	(B)	For Participants with four years of Vesting Service under the Plan on December 31, 1997, the vesting schedule is— 

 

					
	 Years of
 Vesting Service
	  	Vesting
Percentage	 
	 4
	  	 	40	% 
	 5
	  	 	100	% 

  

	 	(C)	Participants with five or more years of Vesting Service on December 31, 1997 are 100 percent vested. 

 

	 	(c)	Forfeitures. If a Participant has terminated employment with the Employer and all Affiliates, any portion of his Accrued Benefit in which the Participant is not
vested shall be forfeited and canceled as of the Participant’s Termination of Employment, subject to reinstatement as provided in sections 3.3 and 3.4; provided, however— 

  
 29 

  

	 	(1)	If a Member’s Termination of Employment occurs when the Member’s vesting percentage is zero, the Member’s Vesting Service, Benefit Service, and Accrued
Benefit shall not be reinstated upon reemployment by an Employer or a nonparticipating Affiliate if, prior to such reemployment, he incurred five consecutive one-year Breaks in Service, as defined in paragraph (3) below.

  

	 	(2)	If a Member’s Termination of Employment occurs when the Member’s vesting percentage is greater than zero but less than 100 percent and the Member receives a
distribution of the present value of his entire nonforfeitable Accrued Benefit (i.e., less than the full present value of his Accrued Benefit), the Member’s Accrued Benefit shall not be reinstated upon reemployment by an Employer or a
nonparticipating Affiliate (but his Vesting Service shall be reinstated and, if he is reemployed by an Employer, his Benefit Service shall be reinstated) unless the Member— 

 

	 	(A)	resumes employment covered under the Plan; and 

  

	 	(B)	repays the full amount of such distribution, with interest at the lesser of the rate determined for purposes of Code section 411(c)(2)(C) or the rate specified in
section 5.1(f) of this Plan, before the earlier of— 

  

	 	(i)	five years after the first date on which such reemployment occurs; or 

  

	 	(ii)	the close of the first period of five consecutive one-year Breaks in Service commencing after the distribution. 

 

	 	(3)	For purposes of this section, a one-year break in service is a Plan Year in which the Member obtains fewer than 501 Hours of Service. 

Forfeitures arising under the Plan for any reason shall be used as soon as possible to reduce the Employer’s contributions under the Plan.

  
 30 

 Article 6. Benefits 
 6.1 Normal Retirement Benefits 
  

	(a)	Eligibility. A Member who attains Normal Retirement Age while employed by an Employer or nonparticipating Affiliate shall be eligible to receive a monthly normal
retirement benefit whether or not the Member has actually retired, commencing on the date specified in section 7.1(a). Such Member’s right to his normal retirement benefit shall be 100 percent vested and nonforfeitable.

  

	(b)	Amount. The monthly normal retirement benefit shall be equal to his Accrued Benefit under the Plan calculated as of the date benefit payments begin.

 If a Member continues in employment beyond Normal Retirement Age and his normal retirement benefits commence
during such employment as described in section 7.3, his benefit shall be calculated using the Plan formula in effect when his benefit payments begin. 
 6.2 Early Retirement Benefits 
  

	(a)	Eligibility. A Member who, while employed by an Employer or nonparticipating Affiliate, has attained Early Retirement Age shall be eligible to retire and receive
a monthly early retirement benefit under the Plan, commencing on the date specified in section 7.1(b). 

Notwithstanding the preceding paragraph, an Old American Participant who has at least five years of “actual service,” as defined
in section A.6(a)(1) of the Appendix hereto, shall be entitled to receive an early retirement benefit with respect to his benefit (if any) accrued under section 22.2(a) of the Prior Plan, as described in section A.l(d)(1) of the Appendix hereto, on
the last day of the month coinciding with or next following his fifty-fifth birthday. 
  

	(b)	Amount. A retired Member’s monthly early retirement benefit shall be the greater of— 

 

	 	(1)	the age 65 life annuity value of the lump sum described in section 5.1(a)(2)(i) or (a)(3)(ii) (whichever is applicable), reduced in accordance with section 4.1(c),
4.1(d), 4.1(e), 4.1(f), or 22.3 of the Prior Plan (whichever is applicable), as described in section A.2 of the Appendix hereto; or 

  

	 	(2)	the Member’s Accrued Benefit as of the Annuity Starting Date, adjusted for early commencement by applying the Actuarial Equivalent factors.

 For purposes of paragraph (2), actuarial equivalence shall be determined on the basis of the Applicable
Mortality Table and the Applicable Annual Interest Rate. 
 Notwithstanding the preceding provisions of this section 6.2, the
monthly early retirement benefit of an Old American Participant shall be no less than the benefit (if any) he had accrued under section 22.2(a) of the Prior Plan on December 31, 1997, as described in section A.l (d)(1) of the Appendix hereto,
reduced in accordance with the applicable provisions of section 22.3 of the Prior Plan, as described in section A.2(e) of said Appendix. 

  
 31 

 6.3 Disability Retirement Benefits 

 

	(a)	Disability Incurred Prior to January 1, 1998. Any Member who incurred a Disability prior to January 1, 1998 and thereby qualified to receive credit
toward his retirement benefit pursuant to section 21.1 of the Prior Plan, as described in section A.3 of the Appendix hereto, shall continue to be subject to the provisions of said section 21.1. 

If such Member’s Disability ceases on or after January 1, 1998, he shall cease to receive credit pursuant to the aforementioned
21.1 and, if he again becomes a Participant— 
  

	 	(1)	the Actuarial Equivalent of his Accrued Benefit on the date his active employment resumes shall constitute an initial Cash Balance Account as of that date, determined
pursuant to the actuarial factors and assumptions described in section 5.1(c)(1); and 

  

	 	(2)	his Cash Balance Account shall thereafter be increased pursuant to the provisions of section 5.1(c)(2). 

 

	(b)	Disability Incurred on or After January 1, 1998. 

  

	 	(1)	Eligibility. A Member in active employment with an Employer who incurs a Disability on or after January 1, 1998 and before he receives a normal or early
retirement benefit shall be eligible to receive benefit accruals as described below. 

  

	 	(2)	Amount. 

 (A) If the
Member had ten or more years of Benefit Service on the date the Disability was incurred, he shall receive— 
 (i) credits
to his Cash Balance Account in accordance with section 5.1(c) and, to the extent applicable, section 5.1(d)-(f); and 
 (ii)
Benefit Service for purposes of determining the Member’s benefit under the Prior Plan’s accrued benefit formula, pursuant to section 5.1(a)(3), 
 for the period of his Disability but not for more than ten years and not beyond the earliest of— 
 (I) the date of his Termination of Employment; 
 (II) the date his Disability
ceases; or 
 (III) the date on which he receives or begins to receive, benefit payments under the Plan. 

  
 32 

 (B) If the Member had fewer than ten years of Benefit Service on the date the Disability
was incurred, he shall receive— 
 (i) credits to his Cash Balance Account in accordance with section 5.1(c) and, to the
extent applicable, section 5.1(d)-(f); and 
 (ii) Benefit Service for purposes of determining the Member’s benefit under
the Prior Plan’s accrued benefit formula, pursuant to section 5.1(a)(3), 
 for the period of his Disability but not for
more than the number of years of Benefit Service he had completed on the date the Disability was incurred, and not beyond the earliest of— 
  

	 	I.	the date of his Termination of Employment; 

  

	 	II.	the date his disability ceases; or 

  

	 	III.	the date on which he receives, or begins to receive, benefit payments under the Plan. 

For purposes of clauses (A) and (B) above, Benefit Service shall accrue only under the Prior Plan’s accrued benefit
formula, and not under the current Plan’s formula, and no Vesting Service shall be credited during such period of Disability. 
  

	(c)	Compensation. Notwithstanding section 2.1(r) of the Plan, a Member’s Compensation throughout his period of Disability shall be equal to the Member’s
base rate of pay in effect immediately prior to the time that his Disability commences. 

 6.4 Deferred Vested Retirement
Benefits 
  

	(a)	Eligibility. A Member whose interest in his Accrued Benefit is fully or partially vested pursuant to section 5.2 and who is not eligible to receive a normal or
early retirement benefit shall be eligible to receive a monthly deferred vested retirement benefit under the Plan calculated as of the date benefit payments begin, commencing on the date specified in section 7.1(c). 

 

	(b)	Amount. If benefits commence on the Member’s Normal Retirement Date, the monthly deferred vested retirement benefit shall be equal to the Member’s
vested Accrued Benefit. If the Member’s benefits commence before Normal Retirement Date, the monthly deferred vested retirement benefit shall be determined on the same basis as early retirement benefits described in section 6.2.

 6.5 Preretirement Survivor Annuity Benefits 

 

	(a)	Eligibility. In the case of a Member who prior to his death has a nonforfeitable right to all or a portion of his benefits under the Plan, who has a surviving
Spouse and who dies prior to his Annuity Starting Date (whether or not such Member is employed by the Employer or a nonparticipating Affiliate), there shall be payable to his surviving Spouse a Preretirement Survivor Annuity.

  
 33 

  

	(b)	Amount of Benefits. The monthly payments to a surviving Spouse under the Preretirement Survivor Annuity shall equal the amounts which would have been payable as
a survivor annuity under the Qualified Joint and Survivor Annuity under the Plan if such Member had retired with an immediate Qualified Joint and Survivor Annuity on the day before the Member’s death. 

The amount of the monthly retirement benefit payable to a Member if he does not die prior to his Annuity Starting
Date, and the amount payable to a Spouse under the Preretirement Survivor Annuity, shall not be reduced to reflect coverage under the Preretirement Survivor Annuity. 
 If, pursuant to subsection (c) below, a Spouse elects to defer the commencement of the Preretirement Survivor Annuity, the amount of the benefit payable thereunder shall be increased (as if the
Member had deferred commencement of his benefit) to reflect such deferral; provided, however— 
  

	 	(1)	the surviving Spouse shall not receive any applicable survivor benefits prior to such Spouse’s attainment of age 62 without the surviving Spouse’s consent;
and 

  

	 	(2)	if the surviving Spouse elects to defer receipt of the Preretirement Survivor Annuity until after such Spouse has attained age 60, the Spouse shall receive the
Actuarial Equivalent of the Preretirement Survivor Annuity that would have been payable at age 60. 

 For purposes
of paragraph (2) of this subsection (b), “Actuarial Equivalent” shall be computed on the basis of an interest assumption of 7 percent per year, and mortality using the 1984 Unisex Pension Mortality Table with the ages in that table
set back two years if the surviving spouse elects to defer receipt. 
  

	(c)	Commencement. Payment of the Preretirement Survivor Annuity to a Member’s Spouse shall commence no earlier than the first day of the calendar month
following the date of the deceased Member’s death; provided, however, that a Member’s surviving Spouse may elect, subject to the restrictions of section 7.5, to defer commencement of such payment until the later of the Member’s Normal
Retirement Date or the applicable date under subsection (b)(1) or (2) above. 

 If the surviving Spouse has
properly elected in writing to receive the death benefit provided by this section in a single sum as described in subsection (d) below, then such payment shall be made as soon as administratively practicable after the Spouse’s election.

  

	(d)	Alternative Single Sum. In lieu of the Preretirement Survivor Annuity provided by subsection (b), the surviving Spouse may elect in writing to receive an
immediate single sum payment equal to the greater of— 

  
 34 

  

	 	(1)	the vested portion of the Member’s Cash Balance Account as of the first day of the calendar month preceding the date of distribution; or 

 

	 	(2)	the single sum Actuarial Equivalent of the Preretirement Survivor Annuity. 

 The Spouse’s election to receive a single sum payment under this section shall be filed in the manner and on the form prescribed by the Administrative Committee no later than the first to occur of
the first anniversary of the Member’s death or the date that annuity benefits would become payable under this section. 

For purposes of paragraph (2) of this subsection (d), actuarial equivalence shall be determined on the basis of the Applicable
Mortality Table and the Applicable Interest Rate. 
 6.6 Other Death Benefits 

 

	(a)	Eligibility. In the case of a Member who does not have a Spouse at his death, if the Member dies before benefit commencement, the Member’s Beneficiary shall
receive a single sum payment. 

  

	(b)	Amount and Commencement. The single sum payment shall be equal to the vested portion of Member’s Cash Balance Account as of the first day of the calendar
month, preceding the date of distribution. The single sum payment shall be paid to the Beneficiary as soon as administratively practicable following the Member’s death. 

 6.7 Qualified Joint and Survivor Annuity 
  

	(a)	Eligibility. In the case of a Member who has a Termination of Employment, has a Spouse, and begins to receive benefits under the Plan, except as otherwise
provided in this section and section 6.10, the benefits payable to such Member shall be in the form of a Qualified Joint and Survivor Annuity. 

  

	(b)	Election to Waive. Each Member may elect to waive, or revoke an election to waive, the Qualified Joint and Survivor Annuity form of benefit under the Plan. Any
such election to waive or revocation thereof may be made at any time during the 90-day period ending on the Member’s Annuity Starting Date or within the alternative period described in subsection (c) below. An election made after
December 31, 1984 to waive the Qualified Joint and Survivor form of benefit shall not take effect unless the Spouse of the Member consents in writing to such election and the form of benefit and such consent acknowledges the effect of such
election and is witnessed by a person designated by the Administrative Committee or a notary public. Such a consent shall be irrevocable. Spousal consent shall be effective only with respect to the Spouse signing the consent.

 Spousal consent to a waiver of the Qualified Joint and Survivor Annuity form of benefit shall not be required if
the Member establishes to the satisfaction of the Administrative Committee that such consent may not be obtained because there is no Spouse, because the Spouse cannot be located, or because of such other circumstances as the Secretary of the
Treasury may by regulation prescribe. 

  
 35 

  

	(c)	Notice Requirement. The Administrative Committee shall provide to each Member (by mail or personal delivery), generally not less than 30 days and not more than
90 days before the Member’s Annuity Starting Date, a written explanation with respect to the Qualified Joint and Survivor Annuity form of benefits. Such explanation shall provide the information required pursuant to section 6.8. Notwithstanding
the foregoing— 

  

	 	(1)	effective for Plan Years beginning on and after January 1, 1997, such information may be provided after the Annuity Starting Date but, if this happens, the
applicable election period shall not end before the thirtieth day after the date on which such information is provided, except to the extent that the provisions of this paragraph (1) are limited by the Secretary of the Treasury pursuant to Code
section 417(a)(7)(A)(ii); 

  

	 	(2)	the Member may elect (with any applicable spousal consent) to waive the requirement that the written explanation be provided at least 30 days before the Annuity
Starting Date, and/or to waive the 30-day requirement under paragraph (1) above, if the distribution commences more than seven days after such explanation is provided; and 

 

	 	(3)	a Member’s (and Spouse’s) consent shall not be required where the single sum Actuarial Equivalent of a Member’s vested Accrued Benefit does not
exceed— 

  

	 	(A)	$3,500, if the Annuity Starting Date is before January 1, 1998; or 

  

	 	(B)	$5,000, if the Annuity Starting Date is on or after January 1, 1998; 

 and a single-sum distribution is made pursuant to section 6.12. 
  

	(d)	Amount of Benefits. A Qualified Joint and Survivor Annuity shall be the Actuarial Equivalent of the benefit payable under section 6.1, 6.2, 6.3, or 6.4 expressed
as an annuity for the lifetime of a Member and shall provide payments for the lifetime of a Member with a survivor annuity for the lifetime of the Member’s Spouse. 

Such survivor annuity shall be 50 percent of the amount of the annuity which is payable during the joint lives of the Member and the
Spouse. 

  
 36 

 For purposes of this subsection (d), “Actuarial Equivalent” means a benefit
determined on the basis of the factor shown below multiplied by the amount of the Straight Life Annuity under section 6.1, 6.2, 6.3, or 6.4 (as applicable). The factor to be used is determined by subtracting the age at last birthday of the Spouse at
the Member’s Annuity Starting Date from the age at last birthday of the Member at said Annuity Starting Date, in accordance with the following table: 
  

							
	 Age of Member Minus Age of
Spouse

	 Years
	 	 Factor
	 	 Years
	 	 Factor

	 -10 or More
	 	.959	 	11	 	.867
	 -9
	 	.956	 	12	 	.862
	 -8
	 	.953	 	13	 	.857
	 -7
	 	.949	 	14	 	.852
	 -6
	 	.946	 	15	 	.847
	 -5
	 	.942	 	16	 	.842
	 -4
	 	.938	 	17	 	.837
	 -3
	 	.934	 	18	 	.833
	 -2
	 	.930	 	19	 	.828
	 -1
	 	.926	 	20	 	.823
	 0
	 	.921	 	21	 	.818
	 1
	 	.917	 	22	 	.814
	 2
	 	.912	 	23	 	.809
	 3
	 	.907	 	24	 	.805
	 4
	 	.902	 	25	 	.801
	 5
	 	.898	 	26	 	.796
	 6
	 	.893	 	27	 	.792
	 7
	 	.888	 	28	 	.788
	 8
	 	.883	 	29	 	.784
	 9
	 	.878	 	30	 	.780
	 10
	 	.873	 		 	

 As an example of the foregoing, consider a retiring Member who shall be entitled to $1,000 per
month earned retirement income, with a Spouse five years younger. The $1,000 of the Member’s income may be multiplied by the factor of .898 to provide a monthly benefit of $898 during the Member’s lifetime, and $449 as a monthly benefit to
the Spouse after the Member’s death. 
 6.8 Explanation Relating to Survivor Annuities 

The written explanation required pursuant to section 6.7(c) shall describe the terms and conditions of the Qualified Joint and Survivor Annuity, the
Member’s right to make (and the effect of) an election to waive such annuity, the right of the Member’s spouse to consent in writing to such waiver, the right to make (and the effect of) a revocation of an election to waive such annuity,
and the relative value and form of optional forms of payment available under the Plan. 
 6.9 Straight Life Annuity 

 

	(a)	Eligibility. In the case of a Member who has a Termination of Employment, has no Spouse, and begins to receive benefits under the Plan, except as otherwise
provided in this section, the benefits payable to such Member shall be in the form of a Straight Life Annuity. 

  

	(b)	Election to Waive. Each Member may elect to waive, or revoke an election to waive, the Straight Life Annuity form of benefit under the Plan. Rules similar to
those in section 6.7(b) shall govern the Member’s rejection of the Straight Life Annuity and the Member’s ability to revoke such rejection. 

  

	(c)	Amount of Straight Life Annuity. Under the Straight Life Annuity, the monthly retirement benefit payable to Member shall be the benefit described in section 6.1,
6.2, 6.3, or 6.4. 

  
 37 

  

	(d)	Commencement and Duration. The monthly benefit payable to the Member under this section 6.9 shall commence as prescribed under section 7.1(a), (b), or (c), as
applicable with respect to the Member’s retirement benefits, and shall be paid monthly thereafter as of the first day of each succeeding calendar month until (and including) the calendar month of the Member’s death. Thereafter, no benefit
shall be payable with respect to that Member. 

 6.10 Optional Methods of Payment 

 

	(a)	Methods. In lieu of the Straight Life Annuity described in section 6.9 or, if applicable, the Qualified Joint and Survivor Annuity described in section 6.7, a
Member, other than a Member who is subject to the cashout rules of section 6.12, may elect to receive an optional method of payment. Rules similar to those in section 6.7(b) shall govern the Member’s election and the Member’s ability to
revoke such election. The Actuarial Equivalent of any retirement benefit under this Plan to which such Member is or will become entitled as provided heretofore shall be payable in an optional form determined as follows: 

 

	 	(1)	If the Member has attained Normal Retirement Age or Early Retirement Age on his Annuity Starting Date, the optional forms available to, him shall be—

  

	 	(A)	lump sum; 

  

	 	(B)	Straight Life Annuity; 

  

	 	(C)	50% Joint & Survivor Annuity with his Spouse as the contingent annuitant (but only if the Member has a Spouse on the Annuity Starting Date);

  

	 	(D)	100% Joint & Survivor Annuity with his Spouse as the contingent annuitant (but only if the Member has a Spouse on the Annuity Starting Date);

  

	 	(E)	10-Year Certain and Life Annuity, as described in section 22.4(a) of the Prior Plan and section A.5 of the Appendix hereto, but only if the Member is an Old American
Participant, and only with respect to the portion of the Accrued Benefit that is derived from the Employees Retirement Plan of Old American Insurance Company; or 

 

	 	(F)	the sum of— 

  

	 	(i)	the Member’s Prior Plan Benefit on December 31, 1997 payable in any of the above forms otherwise available to the Member, other than a lump sum, with annual
cost-of-living increases determined in the manner prescribed in the Prior Plan, as described in section A.4 of the Appendix hereto, which annuity shall be the Actuarial Equivalent of the Straight Life Annuity; and 

 

	 	(ii)	the Member’s post-1997 cash balance accruals under section 5.1 of this Plan payable in any of the above forms otherwise available to the Member (including a lump
sum) provided, however, that if such accruals are taken in a form other than a lump sum, they shall be paid in the same form in which the Member’s pre-1998 accrued benefit is paid pursuant to (F)(i) above, but without annual cost-of-living
increases. 

  
 38 

  

	 	(2)	If such Member has not attained Normal Retirement Age or Early Retirement Age as of his Annuity Starting Date, the only optional forms payable to him prior to the date
he attains Normal Retirement Age or Early Retirement Age shall be— 

  

	 	(A)	lump sum; or 

  

	 	(B)	the Actuarial Equivalent of his Accrued Benefit, payable as an immediate Straight Life Annuity if the Member has no Spouse on the Annuity Starting Date, or as an
immediate Qualified Joint and Survivor Annuity if the Member has a Spouse on the Annuity Starting Date. 

  

	 	(3)	For purposes of this subsection (a), actuarial equivalence shall be based on the factors used for the corresponding options in the Plan as in effect on
December 31, 1997, except— 

  

	 	(A)	actuarial equivalence for a lump sum shall be based on the Applicable Mortality Table and the Applicable Interest Rate; 

 

	 	(B)	actuarial equivalence for the 100% Joint & Survivor Annuity shall be based on the 1983 Group Annuity Mortality Table, as published, and a 7 percent interest
rate assumption; and 

  

	 	(C)	actuarial equivalence for the 10-Year Certain and Life Annuity shall be based on the 1984 Unisex Pension Mortality Table, with the ages in that table set back two
years, and a 7 percent interest rate assumption. 

  

	(b)	Effect of Death. If a Member elects an optional form of payment other than a 100% Joint & Survivor Annuity with his Spouse as contingent annuitant and
dies before the Annuity Starting Date, the election shall be void and his Spouse or his Beneficiary, if living, shall receive the benefit, if entitled thereto, under section 6.5 or 6.6 (as applicable). 

If a Member elects a 100% Joint & Survivor Annuity optional form of payment and dies before the Annuity Starting Date, the
election shall be valid and his surviving Spouse shall receive the benefit that the Spouse was entitled to receive under the optional form elected by the Member. 
 6.11 Maximum Annual Benefits 
  

	(a)	General Rule. Notwithstanding any other provision of this Plan to the contrary, in no event may the annual Accrued Benefit provided under this Plan (together
with that provided by all other defined benefit plans of the Employer and all nonparticipating Affiliates) for any Member for a “Limitation Year,” which shall be the calendar year, exceed the maximum amount permitted by Code section 415(b)
for that Limitation Year. 

  

	(b)	Definition of Affiliate. In applying the limitations on benefits hereunder, the qualified plans of any employer which is not an Employer or nonparticipating
Affiliate under the Plan shall be aggregated with the Plan or any other plan of the Employer or nonparticipating Affiliate if the employer would be an Affiliate if the phrase “at least 80 percent” in Code section 1563(a)(1), in applying
such section to Code sections 414(b) or 414(c), were replaced with “more than 50 percent.” 

  
 39 

  

	(c)	Combined Plan Limit. In the event that any Member is a participant in a defined contribution plan or plans of the Employer or any nonparticipating Affiliate, the
sum of the defined benefit plan fraction and the defined contribution plan fraction (as such terms are defined in Code section 415(e)) for any Limitation Year with respect to such Member shall not exceed one. If such sum would otherwise exceed one,
then the Member’s retirement benefit under this Plan shall be reduced to comply with the requirements of this subsection. For Limitation Years beginning on and after January 1, 2000, this subsection (c) shall not apply.

  

	(d)	Participation in More than One Defined Benefit Plan. In the event that the Member participates in any other defined benefit plan of the Company or an Affiliate,
and the Member’s aggregate annual retirement benefit under this Plan and such other plan exceeds the limits permitted under Code section 415, such Participant’s benefit shall be first reduced under this Plan. 

 

	(e)	TEFRA/TRA’86 Minimum Benefits. In no event shall the maximum benefit payable under this section be less than the Member’s accrued benefit calculated
under the Plan as in effect on December 31, 1986 or December 31, 1982, as limited by the Code section 415 limits in effect on those dates. 

  

	(f)	RPA’94 Minimum Benefit. 

  

	 	(1)	RPA’94 Freeze Date. The “RPA’94 Freeze Date,” as that term is defined in IRS Revenue Ruling 98-1, shall be January 1, 1998. The
effective date of the Plan amendment implementing the changes under Code section 415(b)(2)(E) shall be January 2, 1998. 

  

	 	(2)	Transition Rules. For purposes of determining the Member’s annual benefit under this Plan, and the related limitations under Code section 415, as applied to
benefits accrued both before and after the RPA ‘94 Freeze Date, Method 3 (the extended wear-away approach) or IRS Revenue Ruling 98-1, Question and Answer 14 shall be applied. 

 

	(g)	Cost-of-Living Adjustments. The dollar amount described in Code section 415(b)(1)(A) and the compensation amount described in Code section 415(b)(1)(B) shall be
adjusted annually for increases in the cost of living, as permitted under Code section 415(d). The annual dollar limit for the 1999 limitation year is $130,000; as of January 1 of each following calendar year, the dollar limit shall be
increased, if and to the extent permitted by the Commissioner of Internal Revenue. Adjustments to the dollar limit shall apply to all Members. Adjustments to the compensation limit shall apply to Members who have terminated employment with all
Affiliates. 

 6.12 Payment of Small Amounts 
 Any other provision of the Plan notwithstanding, the Member’s vested Accrued Benefit or Preretirement Survivor Annuity shall be paid in a single sum if, prior to the commencement of distributions,
its single sum value does not exceed— 
  

	(a)	$3,500, if the Annuity Starting Date is prior to January 1, 1998; or 

  
 40 

  

	(b)	$5,000, if the Annuity Starting Date is on or after January 1, 1998. 

 Effective as of January 1, 1998, the $5,000 limit shall apply not only for purposes of paying out immediate lump sum distributions to Members who incur a Break in Service on or after January 1,
1998, but also to Members who have incurred a Break in Service at any time prior to that date, and whose benefit has not yet commenced. The Employers shall establish reasonable procedures to identify and pay out these terminated vested Members.

 The single sum value shall equal the greater of 
  

	 	(1)	the Actuarial Equivalent of the Member’s vested Accrued Benefit or Preretirement Survivor Annuity, as applicable (determined under section 5.1(a), to the extent
appropriate); or 

  

	 	(2)	the Member’s vested Cash Balance Account; 

determined as of the date of the distribution. 

Upon Termination of Employment, a Participant whose vested percentage under section 5.2 is zero shall be deemed to have received a lump-sum payment of $0
and his Accrued Benefit shall be treated as an immediate forfeiture. This deemed distribution shall represent the entire benefit to which such Participant was entitled under the Plan, in lieu of all other benefits under the Plan. 

This paragraph provides transitional rules with regard to distributions made prior to October 17, 2000. If the value of a Member’s vested
accrued benefit derived from Employer and Employee contributions exceeds (or at the time of any prior distribution (1) in Plan Years beginning before August 6, 1997 exceeded $3,500 or (2) in Plan Years beginning after August 5,
1997 exceeded) $5,000 and the accrued benefit is immediately distributable, the Member and the Member’s spouse (or where either the Member or the spouse has died, the survivor) must consent to any distribution of such accrued benefit.

 6.13 No Rollover or Trust-to-Trust Transfer to the Plan 
 No Participant shall be permitted to make a rollover to this Plan or to have a trust-to-trust transfer made on his behalf to this Plan of any benefit previously received by the Participant from any other
plan or accrued by the Participant under any other plan. 
 6.14 Direct Rollover from the Plan 

 

	(a)	In General. Notwithstanding any provision of the Plan to the contrary that would otherwise limit a Distributee’s election, a Distributee (as defined in
subsection (b)) may elect at the time and in the manner prescribed by the Administrative Committee, to have any portion of an Eligible Rollover Distribution (as defined in subsection (b)) paid directly to an Eligible Retirement Plan (as defined in
subsection (b)) specified by the Distributee in a Direct Rollover (as defined in subsection (b)). 

  
 41 

	(b)	Definitions. 

  

	 	(1)	Eligible Rollover Distribution shall mean any distribution of all or any portion of the balance to the credit of the Distributee, except that an Eligible
Rollover Distribution shall not include: any distribution that is one of a series of substantially equal periodic payments (not less frequently than annually) made for the life (or life expectancy) of the Distributee or the joint lives (or joint
life expectancies) of the Distributee and the Distributee’s designated beneficiary, or for a specified period of ten years or more; any distribution to the extent such distribution is required under Code section 401(a)(9); and the portion of
any distribution that is not includible in gross income (determined without regard to the exclusion for net unrealized appreciation with respect to employer securities). 

 

	 	(2)	Eligible Retirement Plan shall mean an individual retirement account described in Code section 408(a), an individual retirement annuity described in Code section
408(b), an annuity plan described in Code section 403(a), or a qualified trust described in Code section 401(a), that accepts the Distributee’s Eligible Rollover Distribution. However, in the case of an Eligible Rollover Distribution to the
surviving spouse, an Eligible Retirement Plan is an individual retirement account or individual retirement annuity. 

  

	 	(3)	Distributee shall mean an Employee or former Employee. In addition, the Employee’s or former Employee’s surviving spouse and the Employee’s or
former Employee’s spouse or former spouse who is an alternate payee under a qualified domestic relations order, as defined in Code section 414(p), are Distributees with regard to the interest of the spouse or former spouse.

  

	 	(4)	Direct Rollover shall mean a payment by the Plan to the Eligible Retirement Plan specified by the Distributee. 

 

	(c)	Notice. The Administrative Committee shall provide all Members with information on the Direct Rollover election. Such information and election shall be intended
to comply in all respects with final Treasury regulations regarding such information and election. 

  
 42 

 Article 7. Commencement of Payments and Duration 

7.1 Commencement 
 The monthly retirement
benefit payments to which an eligible Member is entitled under section 6.1, 6.2, 6.3, or 6.4 shall begin as described below and shall then be payable pursuant to the applicable method of payment under section 6.7, 6.9, or 6.10: 

 

	(a)	Normal Retirement Benefits. 

  

	 	(1)	A Member entitled to a benefit under section 6.1 shall start receiving such benefit on the first day of the month following the earlier of the Member’s Termination
of Employment or the month that he is employed at a rate of fewer than 40 Hours of Service. 

  

	 	(2)	A Member entitled to a benefit under section 6.1 who continues his employment past his Normal Retirement Age at a rate of 40 or more Hours of Service per month shall
have his normal retirement benefits suspended in the manner described in section 7.3 and he shall receive the notice described in section 7.4. 

  

	(b)	Early Retirement Benefits. A Member entitled to a benefit under section 6.2 shall start receiving such benefit on the first day of the month following the
Member’s Termination of Employment unless he elects prior to his Termination of Employment to defer commencement until a later date. In no case shall a Member be permitted to defer commencement until later than the Member’s Normal
Retirement Date. 

  

	(c)	Deferred Vested Retirement Benefits. A Member entitled to a benefit under section 6.4, other than a Member who is subject to the cashout rules of section 6.12,
shall start receiving such benefit on his Normal Retirement Date, except that the Member shall have the right to begin receiving monthly deferred vested retirement benefits either 

 

	 	(1)	as of the first day of the calendar month following the date of the Member’s Termination of Employment, in the case of an annuity, or as soon as administratively
practicable following the Member’s Termination of Employment, in the case of a single-sum payment; or 

  

	 	(2)	as of a later date that is as soon as administratively practicable following the date that the Member’s written application is properly filed with the
Administrative Committee, but in no event later than the Member’s Normal Retirement Date. 

  
 43 

 7.2 Employee Status 
 A Member who retires or otherwise has a Termination of Employment under the terms of the Plan shall cease to be an Employee upon such retirement or Termination of Employment. 

7.3 Suspension of Benefits 
  

	(a)	Reemployment Before Attaining Normal Retirement Age. If a Member is reemployed as an Employee before his Normal Retirement Age and before his full vested benefit
under the Plan (prior to such reemployment) has been distributed, any monthly benefit payments being made to such a Member shall be discontinued and shall not be paid during the Member’s reemployment. The Member’s previous election of
payment form shall be canceled and the Vesting Service (and Benefit Service) that the Member had at the time of his prior Termination of Employment shall be reinstated. Any portion of the Member’s benefit which was forfeited upon prior
Termination of Employment shall also be reinstated. 

 Upon the Member’s subsequent retirement, his benefit
under the Plan shall be paid as if the Member were then first retired, but such benefit shall be reduced by the Actuarial Equivalent (ignoring mortality) of the benefit payments the Member previously received. If the Member dies during such
reemployment, no payments shall be made under section 6.1, 6.2, or 6.4. Death benefits shall be paid only pursuant to sections 6.5 and 6.6, subject to the offset described in this subsection. 

 

	(b)	Employment or Reemployment on or After Attaining Normal Retirement Age and After Benefit Commencement. If a Member who has commenced benefits remains employed or
is reemployed as an Employee after attaining Normal Retirement Age but before his full vested benefit under the Plan (prior to such reemployment) has been distributed then monthly benefit payments shall continue during the period of such employment
or reemployment. 

 The Member shall also continue to accrue post-retirement benefits in accordance with section
5.1 for the period of employment or reemployment, but such benefits shall not be paid until the Member first or again incurs a Termination of Employment unless the Member obtains fewer than 40 Hours of Service in any calendar month. Upon the
Member’s subsequent retirement, the post-retirement benefit accruals shall be added to the Member’s benefit already in pay status and shall be paid as a separate benefit in any form available under Article 6 to the Member, subject to any
applicable election or consent requirements thereunder. Section 6.12 (concerning small amount cashouts) shall not apply to post-retirement benefit accruals described in this section. 

 

	(c)	Employment or Reemployment on or After Attaining Normal Retirement Age Without Benefit Commencement. If a Member remains employed or is reemployed as an Employee
after attaining Normal Retirement Age at a rate of at least 40 Hours of Service per month and his benefits have not commenced, he shall be provided with a suspension of benefits notice, in accordance with Department of Labor Regulations and such
rules as the Administrative Committee may prescribe, stating that the normal retirement benefit payments to which the Member is entitled are not being paid because of the Member’s continued employment or reemployment. 

  
 44 

 If a Member remains employed or is reemployed as an Employee after attaining Normal
Retirement Age at a rate of less than 40 Hours of Service per month, he shall receive the same type and amount of benefit payment he was entitled to receive at his Normal Retirement Age or preceding his reemployment 

7.4 Suspension of Benefits Notice and Procedures 
 If an Employee’s benefits are to be suspended after Normal Retirement Age, the Administrative Committee shall notify the Employee, by personal delivery or first class mail during the first calendar
month in which payments are withheld, that benefits are suspended. The notice shall contain— 
  

	(a)	a general description of the reasons why payments are suspended; 

  

	(b)	a general description of the Plan provisions relating to the suspension of benefits; 

 

	(c)	a copy of such Plan provisions; 

  

	(d)	a statement that applicable Department of Labor regulations may be found in section 2530.203-3 of the Code of Federal Regulations; 

 

	(e)	a statement that a review of the suspension may be requested under the claims procedure found in section 14.8; 

 

	(f)	if the Plan requires a benefit resumption notice, the procedure and forms; and 

 

	(g)	if the Plan requires verification by the Employee that his benefits should not be suspended, the procedure and forms for such verification. 

7.5 Time Limits for Payment of Benefits 

To comply with the legal restrictions of Code section 40l(a)(9) and the regulations thereunder on the deferral of benefit commencement, all benefit
payments must comply with the following rules, notwithstanding any other Plan provision: 
  

	(a)	Benefit Commencement Requirements. Payment of benefits shall begin as soon as practical after the Member is entitled to receive them (and has properly filed a
benefits election form) but not later than 60 days after the last day of the Plan Year in which occurs the later of— 

  

	 	(1)	the Member’s attainment of Normal Retirement Age; or 

  

	 	(2)	the Member’s Termination of Employment; 

 provided, however, that if the amount of the payments required to commence on a date determined under this section cannot be ascertained or the person entitled thereto cannot be located by that date, a
payment retroactive to that date may be made no later than 60 days after the earliest date on which such amount can be ascertained or such person located. 
  

	(b)	Required Distributions. Notwithstanding any of the preceding provisions of this Plan- 

 

	 	(1)	 For distributions commencing prior to January 1, 1997, in no event may the distribution of a Member’s benefits commence later than the
April 1 of the calendar year following the year in which the Member reaches age 70 1/2. 

  
 45 

  

	 	(2)	 For distributions to Members, other than 5-percent owners, commencing after December 31, 1996 (including distributions to members who attained age
70 1/2 in 1996), in no event may the distribution of
a Member’s benefits commence later than the April 1 of the calendar year following the later of— 

  

	 	(A)	 the year in which the Member reaches age 70 1/2; or 

  

	 	(B)	the year in which the Member’s Termination of Employment occurs. 

For purposes of this subsection, a Member is treated as a 5-percent owner if such Member is a 5 percent owner as
defined in section 416 of the Code at any time during the plan year ending with or within the calendar year in which such owner attains age 70 1/2. Once distributions have been begun to a 5-percent owner under this section, they must continue to be distributed, even if the Member ceases to be a
5-percent owner in a subsequent year. 
  

	 	(3)	 Each Member who attained age
70 1/2 prior to 1996 shall be entitled to make an
election, at the time and in the manner prescribed by the Administrative Committee, effective beginning with the 1997 Plan Year, to suspend benefit payments which commenced pursuant to paragraph (1) until such Member’s Termination of
Employment with the Employer. 

  

	 	(4)	If a Member postpones commencement of his benefits after age 70 1/2, an actuarial adjustment will be made for the post-age 70 1/2 commencement as determined by the
Administrative Committee in accordance with any applicable guidance provided in Treasury regulations or prescribed by the Commissioner of the Internal Revenue Service in ruling, notices or other guidance. 

 

	(c)	Distributions to be Made in Accordance With Treasury Regulations. With respect to distributions under the Plan made on or after January 1, 2001 for calendar
years beginning on or after January 1, 2001, the Plan will apply the minimum distribution requirements of Code section 401(a)(9) in accordance with the regulations under section 401(a)(9) that were proposed on January 17, 2001,
notwithstanding any provision of the Plan to the contrary. This section 7.5(c) shall continue in effect until the end of the last calendar year beginning before the effective date of final regulations under Code section 401(a)(9) or such other date
as may be specified in the guidance published by the Internal Revenue Service. 

 7.6 Withholding Taxes 

An Employer may withhold from a Member’s compensation and the Trustee may withhold from any payment under this Plan any taxes required to be withheld
with respect to contributions or benefits under this Plan and such sum as the Employer or Trustee may reasonably estimate as necessary to cover any taxes for which they may be liable and which may be assessed with respect to contributions or
benefits under this Plan. 

  
 46 

 Article 8. Funding 
 8.1 Company Contributions 
 The Company shall contribute the full cost of retirement
benefits for all participating Employees. 
 8.2 Nonreversion 
 No Employer shall have any right, title, or interest in the contributions made by it under the Plan and no part of the Trust Fund shall revert to it or for its benefit, except that— 

 

	(a)	Employer contributions are expressly conditioned upon initial qualification of the Plan as to the Employer. In the event that the Internal Revenue Service initially
determines that the Plan does not constitute a qualified employee pension plan meeting the requirements of Code section 401 (a) with respect to any Employer’s initial adoption of the Plan, then the Plan shall be null and void from the
coverage date with respect to such Employer. Any funds in the Trust Fund at the time of such unfavorable determination which have been contributed by that Employer shall be returned to that Employer within one year after the date of such denial of
qualification unless the Plan is amended and a favorable determination obtained as of the coverage date applicable to such Employer. 

  

	(b)	Upon termination of the Plan (after a favorable determination described in (a) has been obtained) with respect to any Employer and the allocation and distribution
of the Trust Fund as provided in section 16.2, any funds remaining in the Trust Fund with respect to that Employer after the satisfaction of all fixed and contingent liabilities under the Plan with respect to that Employer may revert to that
Employer, as further described in section 16.4. 

  

	(c)	If a contribution is made to the Trust Fund by any Employer by a mistake of fact, then such contribution may be returned to that Employer within one year after the
payment of the contribution. 

  

	(d)	Employer contributions are expressly conditioned upon deductibility of contributions under Code section 404, and if any part of all of a contribution is disallowed as a
deduction under Code section 404 with respect to any Employer, then to the extent a contribution is disallowed as a deduction, it may be returned to that Employer within one year after the later of the date of payment of the contribution or the date
the deduction for the contribution was disallowed. 

 Any contributions returned to the Employer under subsection (a), (c) or
(d) above shall not include any investment earnings thereon but shall be net of any investment losses thereon. 

  
 47 

 Article 9. Allocation of Fiduciary Responsibility 

9.1 Fiduciaries 
 The fiduciaries shall
have only those specific powers, duties, responsibilities and obligations as are specifically given them under this Plan. The Company shall have the sole responsibility for— 

 

	(a)	making the contributions required to fund the benefits authorized by the provisions of Article 5; 

 

	(b)	appointing and removing the Trustees and members of the Administrative Committee; and 

 

	(c)	amending or terminating; in whole or in part, this Plan and Trust. 

 9.2 Administrative Committee 
 The Administrative Committee shall have the sole
responsibility for the administration of this Plan, which responsibility is specifically described in Article 14. 
 9.3 Trustees

 The Trustees shall have the sole responsibility for the administration and management of the assets held pursuant to this Plan and Trust,
all as specifically provided for herein. 
 9.4 Fiduciary Responsibility 
 Each fiduciary warrants that any direction given, information furnished, or action taken by it shall be in accordance with the provisions of the Plan and Trust, authorizing or providing for such
direction, information or action. Furthermore, each fiduciary may rely upon any such direction, information, or action of another fiduciary as being proper under this Plan, and is not required herein to inquire into the propriety of any such
direction, information, or action. It is intended under this Plan that each fiduciary shall be responsible for the proper exercise of its own powers, duties, responsibilities, and obligations pursuant to the Plan and shall not be responsible for any
act or failure to act of another fiduciary. No fiduciary guarantees the Trust fund in any manner against investment loss or depreciation in asset value. 

  
 48 

 Article 10. The Trustees 
 10.1 Number of Trustees 
 There shall be three Trustees for this Trust, appointed by the
Company. 
 10.2 Trust Funds 
 The Trustees shall accept and receive all sums of money paid to them from time to time by the Company, and shall hold, invest, reinvest, manage, and administer such moneys and the increment, increase,
earnings, and income thereof as a Trust for the exclusive benefit of the Employees participating in the Plan, and their beneficiaries. All income and earnings of the Trust shall be accumulated by the Trustees and by them held, invested, and
reinvested as a part of the principal of the said Trust. 
 10.3. Investment of Funds 

 

	(a)	The Trustees shall invest and reinvest the principal and income of the Trust in their discretion in such securities, common and preferred stocks, real estate mortgages,
debentures, bonds, promissory notes, real estate, real estate improvements, leaseholds, or any other income-producing properties or securities, real or personal, within or without the State of Missouri, and other investments as the Trustees shall,
after investigation, believe to be sound and suitable investments for this Trust, although the same may not be of the character permitted for trustees’ investments by the Laws of the State of Missouri. The Trustees are specifically empowered to
invest the Trust assets in the capital stock of Kansas City Life Insurance Company as well as in a deposit administration annuity contract, or any similar type policy contract, made available by Kansas City Life Insurance Company.

  

	(b)	The Trustees may retain in cash so much of the Trust assets as they may deem advisable. 

 

	(c)	The Trustees may sell property held by the Trust at either public or private sale, for cash or on credit, at such times as they may deem appropriate; they may exchange
such property, and they may grant options for the purchase or exchange thereof. 

  

	(d)	The Trustees may consent to and participate in any plan or reorganization, consolidation, merger, extension or other similar plan affecting property held by the Trust;
they may consent to any contract, lease, mortgage, purchase, sale, or other action by any corporation pursuant to any such plan; they may accept and retain property issued under any such plan, even though it would not be eligible as a new investment
under the provisions of this section. 

  

	(e)	The Trustees may deposit property held in the Trust with any protective, reorganization, or similar committee, and may delegate discretionary power thereto

 Section 10.1 
 46 
 to pay its reasonable share of such committee’s expenses and
compensation and any assessments levied with respect to any property so deposited. 

  
 49 

  

	(f)	The Trustees may exercise all conversion and subscription rights pertaining to property held in the trust. 

 

	(g)	The Trustees may exercise all voting rights with respect to property held in the Trust, and in connection therewith grant proxies discretionary or otherwise, all in
accordance with the provisions of this Plan and Trust. 

  

	(h)	The Trustees may cause securities and other property to be registered and held in their names, the name of any one of them, or in the name of their nominee.

  

	(i)	The Trustees may compromise, compound, and. settle any Trust, and pledge or mortgage securities or other assets owned by the Trust as security for the payment thereof.

  

	(j)	The Trustees may compromise, compound, and settle any debtor obligation due to or from them as Trustees; they may reduce the rate of interest on any obligation due them
as Trustees; they may extend the time of payment of both interest and principal, or otherwise modify the terms of any obligation due them as Trustees; upon default of any obligation due them as Trustees, they may foreclose or otherwise enforce any
obligation belonging to the Trust. 

  

	(k)	The Trustees may generally do all such acts, execute all such instruments, take all such proceedings, and exercise all such rights and privileges with relation to
property belonging to the Trust as if the Trustees were the absolute owners thereof. 

  

	(1)	The Trustees (or any investment manager appointed by the Trustees) may cause all or part of the assets of this Plan and Trust for which they have investment
responsibility to be invested in any common, collective, or commingled trust, or pooled investment fund qualified under Code section 401(a) and exempt from taxation under Code section-501(a). To the extent assets of this Plan and Trust are invested
in any such common, collective, or commingled trust, or pooled investment fund, the terms and provisions of the documents under which such trust or fund are maintained (as amended from time to time) shall govern any investment therein, and such
terms and provisions are hereby incorporated into and made a part of this Plan and Trust. 

 10.4 Prior Approval of Investments

 Any investments or reinvestments of any funds of this Trust by the Trustees shall be subject to the prior approval of and/or reporting to
the Investment Committee of the Company or the Executive Committee of the Company in accordance with requirements established by resolution of the Executive Committee pertaining to the Investment Committee and as amended from time to time. However,
this section 10.4 shall not apply to any investments or reinvestments made by an investment manager appointed by the Trustees. 
 10.5
Disbursements 
 Disbursement of the funds of this Trust shall be made by the Trustees only to or for the benefit of the Members of the Plan
or their beneficiaries, and only at the time, in the amount and in the manner prescribed in written instructions of the Administrative Committee delivered by such Committee to the Trustees. The Trustees are empowered to sell securities belonging to
the Trust to meet said disbursements when the cash reserve is insufficient 

  
 50 

 10.6 No Independent Determination 
 The Trustees shall not be obligated or required to determine whether any instructions issued to them by the Administrative Committee are in fact so issued in accordance with the terms of the Plan or the
powers and duties thereunder of said Committee. 
 10.7 Indemnification Insurance 

The Trustees or the Administrative Committee shall have the right to purchase insurance on behalf of themselves or anyone acting in a fiduciary capacity
with respect to the Plan and Trust, to cover liability or losses occurring by reason of the act or omission of a fiduciary, if such insurance permits recourse by the insurer against the fiduciary in the case of a breach of a fiduciary obligation by
such fiduciary. 
 10.8 Annual Account 
 Each year the Trustees shall render to the Company an account of their administration of, the Trust for the year ending on the preceding December 31. The written approval of said account by the Board
of Directors or the Executive Committee, or any designated subcommittee of the Executive Committee, of the Company shall, as to all matters and transactions stated therein or shown thereby, be final and binding upon all persons who are then or who
may thereafter become interested in this Plan and Trust. 
 10.9 Valuation of Assets 

For purposes of applying the applicable minimum funding standard established by the Act, Trust assets are to be valued on the basis of any reasonable
actuarial method of valuation permitted under regulations from time to time. 
 10.10 Remuneration 

No Trustee shall receive any compensation for his services as such Trustee. In the administration of said Trust, the Trustees, if they deem it advisable,
may employ an executive director, secretary, or treasurer and fix reasonable compensation therefore, and a Trustee may act as such executive director, secretary, or treasurer and receive the compensation so fixed. The Trustees may in their
discretion employ clerical help, actuaries, accountants, attorneys, or other necessary personal services of a person or corporation as may be necessary to properly administer, defend, and protect the Trust, and reasonable compensation for said
services may be paid by the Trustees from the Trust in the event the Company does not elect to pay for such services. Any taxes that may be levied against said Trust shall be paid by the Trustees from the Trust assets after liability for said taxes,
if any, has been established, and in determining the liability for taxes the Trustees are specifically authorized to use their own discretion in contesting taxes claimed to be due against said Trust, and said Trustees may employ counsel for such
purposes and pay said counsel fees from the Trust assets in the event the Company does not elect to pay said costs and fees. 
 10.11
Removal, Resignation, and Replacement of Trustees 
 The Trustees administering this Trust shall at all times be officers of the Company, and
any Trustee may at any time be removed from the office of Trustee, with or without cause, by the Company or the Executive Committee of the Company. The Trustees named herein shall serve as such Trustees until their resignation, death, or removal by
the Board of Directors or the Executive Committee. When any Trustee ceases to be an officer of the Company, he 

  
 51 

 
automatically ceases to be a Trustee. Resignation of a Trustee shall be by written notice given to the Board of Directors or the Executive Committee of the Company. Whenever a vacancy occurs by
resignation, death or remoyal of one or more of the Trustees, the Board of Directors or the Executive Committee shall promptly fill said vacancy or vacancies so created by naming a successor Trustee or successor Trustees possessing the
qualifications herein prescribed. All successor Trustees shall have the same powers in connection with said Trust as the initial Trustees have, and they shall be subject to the same limitations and directions as prescribed herein for the initial
Trustees. 
 10.12 Trustees’ Rules 
 The Trustees may make proper rules for carrying out the purposes of the Trust, and may amend said rules from time to time. A majority of the Trustees shall constitute a quorum, and the action taken by a
quorum shall be controlling and shall be deemed the act of the Trustees. The Trustees may designate any one of their number to act as chairman or presiding officer. Any one of the Trustees shall be and is hereby authorized to affix his signature as
the signature of all of the Trustees when such may be desirable in the performance of their duties pursuant hereto. This Plan and Trust shall be construed and enforced according to the laws of the State of Missouri, and all provisions thereof shall
be administered according to the laws of such state. Any suit at law or in equity brought against the Trustees of the Company by any person, firm, or corporation, including the participants in the Plan, must be first instituted in Jackson County,
Missouri, which county and state is the sites of the parties hereto and the only jurisdiction within which this Plan and Trust is to be administered or located. 

  
 52 

 Article 11. Payments to Trust 
 11.1 Company Contributions 
 Contributions of the Company shall be paid to the Trust at any
time during the year as determined by the Company. However, the Company may make advance payments to the Trust from time to time, as it shall deem necessary or desirable. 

  
 53 

 Article 12. Payment of Pensions 
 12.1 Payment to Members 
 Whenever a member shall become entitled to commencement of the
payment of his pension as hereinbefore provided, the Trustees, upon the written direction of the Administrative Committee, shall pay to the Member the pension payments to which he is then entitled. Benefits under this Plan shall be paid only if the
Administrative Committee decides in its discretion that the applicant is entitled to them. The Administrative Committee may direct that such pension shall be paid by the purchase of an annuity or annuities on the life of such member in such amount
and form as will produce the monthly pension payments to which he shall be entitled under this Plan, or that such pension shall be paid directly from Trust assets. If said annuity contracts shall be purchased, they shall be issued to the Trustees.

 12.2 Direction by Administrative Committee 
 The Trustees shall make all disbursements to Members and Beneficiaries in accordance with the directions of the Administrative Committee. 

  
 54 

 Article 13. Inalienability of Benefits and Incompetency 

13.1 Prohibition of Alienation 
 Except as
may be required by a qualified domestic relations order defined in Code section 414(p), or as otherwise provided in Code section 401 (a)(13)(C), no Member shall be entitled, either before or after his retirement, to alienate, assign, or encumber his
right to the benefits provided by this Plan, and should he attempt to do so, or should his creditor or any person claiming against him seek to subject the interest of such Member herein to legal or equitable process, all right of such Member to the
benefits of this Plan shall forthwith pass to such person or persons as such Member shall have appointed to receive the benefits which would have been payable under this Plan in the event of his death, or, if no such beneficiary shall have been so
designated or shall be then living, then to such of his relatives as the Administrative Committee may select. At any time thereafter, the Administrative Committee, in its sole discretion, may restore to such Member his full rights under this Plan.

 13.2 Incompetency 
 Every
person receiving or claiming benefits under the Plan shall be conclusively presumed to be mentally competent and of age until the Administrative Committee receives written notice, in a form and manner acceptable to it, that such person is
incompetent or a minor, and that a guardian, conservator, or other person legally vested with the care of his estate has been appointed. In the event that the Administrative Committee finds that any person to whom a benefit is payable under the Plan
is unable to properly care for his affairs, or is a minor, then any payment due (unless a prior claim therefor shall have been made by a duly appointed legal representative) may be paid to the spouse, a child, a parent, a brother, or a sister, or to
any person deemed by the Administrative Committee to have incurred expense for such person otherwise entitled to payment. 
 In the event a
guardian or conservator of the estate of any person receiving or claiming benefits under the Plan shall be appointed by a court of competent jurisdiction, payments shall be made to such guardian or conservator, provided that proper proof of
appointment is furnished in a form and manner suitable to the Administrative Committee. 
 To the extent permitted by law, any payment made
under the provisions of this section 13.2 shall be a complete discharge of liability under the Plan. 

  
 55 

 Article 14. Administrative Committee 
 14.1 Composition and Responsibility 
 The Administrative Committee, sometimes herein
referred to as the “Committee,” shall consist of a number of persons, not less than three nor more than five, designated by the Executive Committee of the Company, who shall serve terms of one year or until their successors are designated,
and said committee shall have the responsibility for the general administration of the Plan and for carrying out the provisions of the Plan in accordance with its terms. The Committee shall have absolute discretion in carrying out its
responsibilities. 
 14.2 Powers 

The Committee may appoint from its members such committees with such powers as it shall determine; may authorize one or more of its number or any agent to
execute or deliver any instrument or make any payment on its behalf; and may utilize counsel, employ agents, and provide for such clerical and accounting services as it may require in carrying out the provisions of the Plan. 

14.3 Meetings 
 The Committee shall hold
meetings upon such notice, at such place or places, and at such time or times as it may from time to time determine. 
 14.4 Quorum

 The action of a majority of the members expressed from time to time by a vote in a meeting or in writing without a meeting shall
constitute the action of the Committee and shall have the same effect for all purposes as if assented to by all members of the Committee at the time in office. 
 14.5 Compensation and Bonding 
 No member of the Committee shall receive any compensation
for his services as such, and, except as required by law, no bond or other security shall be required of him in such capacity in any jurisdiction. 
 14.6 Rules and Regulations 
 Subject to the limitation of this Plan and Trust, the Committee
from time to time shall establish rules or regulations for the administration of the Plan and the transaction of its business. 
 14.7
Interpretation 
 The Committee shall interpret the Plan and decide any and all matters arising hereunder, including the right to remedy
possible ambiguities, inconsistencies, or omissions. The Committee shall have full and complete discretionary authority to construe and interpret the provisions of the Plan. All interpretations, determinations, and decisions of the Committee in
respect of any matter hereunder shall be final, conclusive, and binding on all parties affected thereby. 
 14.8 Effect of a Mistake

 In the event of a mistake or misstatement as to the eligibility, participation, or service of any Member, or the amount of payments made
or to be made to a Member or Beneficiary, the Administrative Committee shall, if possible, cause to be withheld or accelerated or otherwise make adjustment of such amounts of payments as will in its sole judgment result in the Member or Beneficiary
receiving the proper amount of payments under this Plan. 

  
 56 

 14.9 Adjudication 
 The Administrative Committee shall make all determinations as to the right of any person to a benefit. The Committee shall have full and complete discretionary authority to determine the right of any
person to a benefit. Any denial by the Committee of a claim for benefits under this Plan by a Member or a Beneficiary shall be stated in writing by the Committee and delivered or mailed to the Member or the Beneficiary, whichever is appropriate; and
such notice shall set forth the specific reason for the denial, written to the best of the Committee’s ability in a manner that may be understood without legal or actuarial counsel. In addition, the Committee shall provide a reasonable
opportunity to any Member or Beneficiary whose claim for benefits has been denied for a review of the decision denying the claim. 
 14.10
Reports to Executive Committee 
 The Committee shall, when requested, submit a report to the Executive Committee of the Company giving a
brief account of the operation of the Plan and the performance of the various funds and accounts established pursuant to the Plan. 
 14.11
Resignation and Replacement 
 Any member of the Committee may resign by giving notice to the Executive Committee of the Company at least 15
days before the effective date of his resignation. Any Committee member shall resign upon the request of the Executive Committee. The Executive Committee shall fill all vacancies on the Committee as soon as is reasonably possible after a resignation
takes place, and until a new appointment takes place, the remaining members of the Committee shall have authority to act, if approved by either a majority of the remaining members or by two members, whichever number is lesser. 

14.12 Maintenance of Funding Standard Account 
 The Administrative Committee shall create and maintain a “funding standard account.” Such account shall be in the form of a memorandum account, reflecting amounts held in the Trust, and credits
and charges shall be made to such account to reflect proper funding of the Trust. The funding standard account is to be charged in each Plan Year for the normal costs for that year and with the minimum amortization payment required for initial past
service costs, increases in Plan liabilities, experience losses and waived contributions for each year. Such account is to be credited in each Plan Year for Employer contributions made for that year, with amortized portions of Plan cost decreases
resulting from Plan amendments and experience gains, and with amounts of any waived contributions. 

  
 57 

 Article 15. Amendment and Merger, Consolidation, or Transfer 

15.1 Amendment 
 The Board of Directors of
the Company, or the Executive Committee of the Board of Directors, may amend this Plan at any time by adoption of a written resolution, provided that no such amendment shall— 

 

	(a)	revest any amount of the Trust assets in the Company, or 

  

	(b)	reduce the amount of pension or other benefits theretofore accrued to any Member or the beneficiaries of any deceased Member, or 

 

	(c)	transfer any part of the interests in this Plan of one class of Members to another class of Members, or 

 

	(d)	make possible the diversion of the Trust assets, or any part thereof, to any purpose other than for the exclusive benefit of the employees of the Company or their
beneficiaries. Except as hereinabove provided, the Board of Directors of the Company, or the Executive Committee of the Board of Directors, may amend this Plan in any manner that it deems expedient or proper. 

15.2 Merger, Consolidation, or Transfer 

In the event of any merger or consolidation of the Plan with, or transfer, in whole or in part, of the assets and liabilities of the Trust Fund to another
trust fund held under any other plan of deferred compensation maintained or to be established for the benefit of all or some of the Members of this Plan, the assets of the Trust Fund applicable to such Member shall be transferred to the other trust
fund only if— 
  

	(a)	each Member would (if either this Plan or the other plan then terminated) receive a benefit immediately after the merger, consolidation, or transfer which is equal to
or greater than the benefit he would have been entitled to receive immediately before the merger, consolidation, or transfer (if this Plan had then terminated); 

 

	(b)	resolutions of the Board of Directors of the Company under this Plan, and of any new or successor employer of the affected Members, shall authorize such merger,
consolidation, or transfer; and, in the case of a new or successor employer of the affected Members, its resolutions shall include an assumption of liabilities with respect to such Members’ inclusion in the new employer’s plan; and

  

	(c)	such other plan and trust are qualified under Code sections 401 (a) and 501(a). 

  
 58 

 Article 16. Termination of Plan 
 16.1 Discontinuance of Plan 
 The Company assumes no contractual obligation as to the
continuance of this Plan, and specifically reserves the right, at any time and for any reason, to discontinue this Plan and its contributions thereunder by adoption of a written resolution by the Board of Directors of the Company, or the Executive
Committee of the Board of Directors. Provided, however, that such discontinuance shall not revest the Trust assets as then constituted, or any part thereof, in the Company, except excess assets resulting from actuarial error, and that the: equity in
said assets of each Member and each beneficiary of a deceased Member, as it exists at date of such discontinuance, shall be irrevocable and disbursed to him in the manner set forth in this Article 16, or in Article 17, whichever shall be
appropriate. 
 Within 30 days after the discontinuance of this Plan, the Administrative Committee shall give written notice thereof to the
Trustees and to each Member and each beneficiary of a deceased Member, if any. 
 16.2 Distribution on Discontinuance 

Upon termination of the Plan, or upon termination of employment of a group of Participants constituting a partial termination of the Plan, each such
Member’s Accrued Benefit, calculated as of the date of termination, shall become fully vested and. nonforfeitable to the extent funded. The assets of the Trust fund, or the portion thereof segregated because of a partial termination, shall be
liquidated (after provision is made for the expenses of liquidation) by the payment or provision for the payment of benefits in the order of preference presented by section 4044 of the Act. 
 16.3 Distribution Medium 
 Subject to the foregoing provisions of this Article 16, any
distribution after termination of the Plan may be made, in whole or in part, to the extent that no discrimination in value results, in cash, in securities or other assets in kind, or in nontransferable annuity contracts, as the Administrative
Committee in its discretion shall determine. 
 16.4 Reversion to Company 
 In no event shall the Company receive any amounts from the Trust fund upon termination of the Plan, except that, and notwithstanding any other provision of the Plan, the Company shall receive such
amounts, if any, as may remain after the satisfaction of all liabilities of the Plan and arising out of any deviations between actual requirements and expected actuarial requirements. 

  
 59 

 Article 17. Temporary Restrictions on Benefits 

17.1 Temporary Limitation on Benefits of Restricted Members 
  

	(a)	Plan Termination. In the event of the termination of the Plan, the benefit of any Highly Compensated Employee (and any former Highly Compensated Employee) is
limited to a benefit that is nondiscriminatory under Code section 401(a)(4). 

  

	(b)	Restriction. Notwithstanding any Plan provision to the contrary, the retirement benefits provided under the Plan from Employer contributions for Members
described in subsection (c) below will be restricted to an amount equal to the payments that would be made on the Member’s behalf under a Straight Life Annuity that is the Actuarial Equivalent of the sum of the Member’s Accrued
Benefit and the Member’s other benefits (if any) under the Plan. 

  

	(c)	Restricted Members. The Members subject to the restrictions set forth in subsection (b) are those Members who are both— 

 

	 	(1)	Highly Compensated Employees or former Highly Compensated Employees (as defined in Code section 414(q)); and 

 

	 	(2)	within the group of the 25 of such Highly Compensated Employees or former Highly Compensated Employees with the largest amount of compensation (as defined in Code
section 414(s)) in the current or any prior year. 

  

	(d)	Nonapplicability. The restrictions in this section 17.1 will not apply, however, if— 

 

	 	(1)	after taking into account payment to or on behalf of the restricted Member of all benefits payable to or on behalf of that restricted Member under the Plan, the value
of the Plan assets equals or exceeds 110 percent of the value of the current liabilities of the Plan as defined in Code section 412(l)(7); 

  

	 	(2)	the value of the benefits payable to or on behalf of the restricted Member is less than 1 percent of the value of current liabilities before distribution;

  

	 	(3)	the value of the benefits payable to or on behalf of the restricted Member does not exceed— 

 

	 	(A)	$3,500, if the Annuity Starting Date is before January 1, 1998; or 

  

	 	(B)	$5,000, if the Annuity Starting Date is on or after January 1, 1998; or 

 

	 	(4)	the Commissioner of Internal Revenue determines that such restrictions are not necessary to prevent the prohibited discrimination that may occur in the event of an
early termination of the Plan. 

  
 60 

  

	(e)	Lump Sum Distribution. In the event that a Member’s lump sum payment under section 6.10(a) is restricted under subsection (b) above, a lump sum payment
may nevertheless be made if the restricted Member enters into an agreement with the Trustee providing for repayment of any part of the distribution which is restricted hereunder in the event the Plan is terminated while such restrictions apply. The
agreement shall provide for adequate security for the obligation of repayment, such as a bond, a segregated individual retirement account, or other security for repayment as may be acceptable to the Administrative Committee unless (and until) one of
the conditions described in subsection (d) above is satisfied. 

  
 61 

 Article 18. Top-Heavy Provisions 
 18.1 Application of Top-Heavy Provisions 
  

	(a)	Single Plan Determination. Except as provided in subsection (b)(2) below, if as of a Determination Date, the sum of the amount of the Section 416 Benefit of
Key Employees and the beneficiaries of deceased Key Employees exceeds 60 percent of the amount of the Section 416 Benefit of all Members and beneficiaries other than former Key Employees, the Plan is top-heavy and the provisions of this Article
shall become applicable. 

  

	(b)	Aggregation Group Determination. 

  

	 	(1)	If as of a Determination Date the Plan is part of an Aggregation Group which is top-heavy, the provisions of this Article shall become applicable. Top-heaviness for the
purpose of this subsection shall be determined with respect to the Aggregation Group in the same manner as described in subsection (a) above. 

  

	 	(2)	If the Plan is top-heavy under subsection (a) above, but the Aggregation Group is not top-heavy, this Article shall not be applicable. 

 

	(c)	Administrative Committee. The Administrative Committee shall have responsibility to make all calculations to determine whether the Plan is top-heavy.

 18.2 Definitions 
  

	(a)	“Aggregation Group” means the Plan and all other plans maintained by the Employer and nonparticipating Affiliates which cover a Key Employee and any
other plan which enables a plan covering a Key Employee to meet the requirements of Code section 401(a)(4) or 410. In addition, at the election of the Administrative Committee, the Aggregation Group may be expanded to include any other qualified
plan maintained by an Employer or nonparticipating Affiliate if such expanded 

 Aggregation Group meets the
requirements of Code sections 401(a)(4) and 410. 
  

	(b)	“Determination Date” means the last day of the Plan Year immediately preceding the Plan Year for which top-heaviness is to be determined.

  

	(c)	“Key Employee” means a Member or any Beneficiary thereof if such Member, for the Plan Year containing the Determination Date or any of the four
preceding Plan Years, is— 

  

	 	(1)	an officer of an Employer or nonparticipating Affiliate who has an annual Compensation greater than 50 percent of the amount in effect under Code section 415(b)(1)(A)
for such Plan Year; provided, however, that no more than the lesser of— 

  

	 	(A)	50 Employees; or 

  

	 	(B)	the greater of— 

  

	 	(i)	three Employees; or 

  
 62 

  

	 	(ii)	10 percent of all Employees; 

shall be treated as officers, and such officers shall be selected from those with the highest annual Compensation in the five-year
period; 
  

	 	(2)	one of the ten Employees having annual Compensation from all Employers and nonparticipating Affiliates for such Plan Year greater than the dollar limit specified in
Code section 415(c)(1)(A) and owning both more than a one-half of 1 percent interest and the largest interests in an Employer or nonparticipating Affiliate; 

 

	 	(3)	a 5-percent owner of an Employer or nonparticipating Affiliate; or 

  

	 	(4)	a 1-percent owner of an Employer or nonparticipating Affiliate having an annual Compensation of more than $150,000. 

Ownership shall be determined in accordance with Code sections 416(i)(1)(B) and (C). For purposes of paragraph (2), if two Employees have
the same ownership interest in an Employer or nonparticipating Affiliate, the Employee having the greater annual Compensation from Employers and nonparticipating Affiliates shall be treated as having a larger interest. 

 

	(d)	“Section 416 Benefit” means the sum of— 

  

	 	(1)	the present value of the benefit credited as of a Determination Date to a Member or beneficiary under the Plan and any other qualified defined benefit plan which is
part of an Aggregation Group; 

  

	 	(2)	the amount credited to a Member’s or beneficiary’s account under a qualified defined contribution plan which is part of an Aggregation Group; and

  

	 	(3)	the amount of distributions to the Member or beneficiary during the five-year period ending on the Determination Date other than a distribution which is a tax-free
rollover contribution (or similar transfer) that is not initiated by the Member or that is contributed to a plan which is maintained by an Employer or nonparticipating Affiliate; 

reduced by— 
  

	 	(4)	the amount of rollover contributions (or similar transfer) and earnings thereon credited as of a Determination Date under the Plan or a plan forming part of an
Aggregation Group which is attributable to a rollover contribution (or similar transfer) accepted after December 31, 1983, initiated by the Member and derived from a plan not maintained by an Employer or nonparticipating Affiliate.

 The present value of the benefits shall be determined as of the most recent valuation date used for the purposes
of Code section 412 which is within the 12-month period ending on the Determination Date. The benefit of a current Member shall be determined as if the Member had a Termination of Employment as of such valuation date. An interest rate assumption of
5 percent and the Applicable Mortality Table shall be used to compute the present value of the benefits. 

  
 63 

 The account or benefit of a Member who was a Key Employee and who subsequently meets none of
the conditions of subsection (c) above for the Plan Year containing the Determination Date is not a Section 416 Benefit and shall be excluded from all computations under this Article. Furthermore, if a Member has not performed services for
an Employer or nonparticipating Affiliate (other than benefits under the Plan) during the five-year period ending on the Determination Date, any benefit for such Member (and any account of such Member) shall not be taken into account in computing
top-heaviness under this Article. 
 18.3 Vesting Requirements 
 If the Plan is determined to be top-heavy with respect to a Plan Year under the provisions of section 18.1, then a Member’s interest in his benefit shall vest in accordance with the schedule
applicable to the Member under section 5.2 or the following schedule, whichever is more favorable to the Member for that Plan Year: 
  

					
	 Years of

Vesting
 Service
	  	Vesting
Percentage	 
		
	 Less than 2
	  	 	0	% 
	 2
	  	 	20	% 
	 3
	  	 	40	% 
	 4
	  	 	60	% 
	 5 or more
	  	 	100	% 

 The vesting provisions described in this
section shall not apply to a Member who does not have an Hour of Service after the Plan becomes top-heavy. If in a subsequent Plan Year the Plan is no longer top-heavy, the vesting provisions that were in effect prior to the time the Plan became
top-heavy shall be reinstated; provided, however, that any portion of a Member’s benefit which was vested prior to the time the Plan was no longer top-heavy shall remain vested, and provided further that a Member who has at least three years of
Vesting Service at the start of such Plan Year shall have the option of remaining under the vesting schedule in effect while the Plan was top-heavy. 
 18.4 Minimum Benefit 
  

	(a)	Minimum Accrual Formula. If the Plan is determined to be top-heavy under the provisions of section 18.1 with respect to a Plan Year, the benefit, when expressed
as an Annual Retirement Benefit (as defined below), of a Member who is not a Key Employee shall not be less than the difference between (1) and (2) where— 

 

	 	(1)	is the product of— 

 (A) the
number of years of Top-Heavy Service (as defined below); and 

  
 64 

 (B) 2 percent of the Member’s average Compensation during the period of the five
consecutive years of Top-Heavy Service during which the Member had the greatest aggregate Compensation; but such product shall not exceed 20 percent of the average Compensation; and 

 

	 	(2)	is the amount of the Annual Retirement Benefit that would be provided by the Member’s account balance attributable to employer contributions under a defined
contribution plan which is included in an Aggregation Group. 

  

	(b)	Definitions.  

  

	 	(1)	Annual Retirement Benefit means a benefit payable annually in the form of a Straight Life Annuity and which commences at Normal Retirement Age. If the benefit is
payable in another form or commences at another time, the amount described in subsection (a) above shall be adjusted on an Actuarial Equivalent basis. Preretirement death benefits shall not cause a reduction in the amount of the benefit.

  

	 	(2)	A year of Top-Heavy Service shall be credited for each year of Benefit Service which is credited with respect to a Plan Year in which the Plan is top-heavy.

 18.5 Collective Bargaining Agreements 
 The requirements of sections 18.3 and 18.4 shall not apply with respect to any Employee included in a unit of Employees covered by a collective bargaining agreement between Employee representatives and an
Employer or nonparticipating Affiliate if retirement benefits were the subject of good faith bargaining between such Employee representatives and such Employer or nonparticipating Affiliate. 

  
 65 

 In Witness Whereof, Kansas City Life Insurance Company has caused this Plan and Trust to be signed
and its corporate seal to be hereunto affixed by its duly authorized officers, and Trustees have caused this Plan and Trust to he signed, effective as of January 1, 2001 or such other dates as are set forth herein or required by law, on this
18 day of December , 2001 
  

	
	Kansas City Life Insurance Company

Attest: 
  

					
	By	 	 /s/ J. Todd Salash

			
		 	Its	 	         Vice President

 

											
	By	 	 /s/ Sandra Kowalski
	 		 		 	
						
		 	Its	 	 Assistant Secretary
	 		 		 	(Corporate Seal)

  

	
	Trustees:
	
	 /s/ Richard L. Finn

	
	 /s/ John K. Koetting

	
	 /s/ Robert C. Miller

  
 66 

 Appendix A. Prior Plan Benefits 
 A.1 Prior Plan Accrued Benefit 
 Each Member’s Prior Plan Benefit shall be his accrued
benefit under the Prior Plan on December 31, 1997, determined in accordance with the following provisions: 
  

	(a)	Effective from January 1, 1985 until December 31, 1997, the accrued benefit of anyone who was or became an employee of the Company on or after January 1,
1985 and who was at least 21 years of age was determined by multiplying his highest 60 consecutive months average salary, derived during his final 120 months of employment, by— 

 

	 	(1)	2.5 percent for each of his first 20 years of employment following his twenty- first birthday; 

 

	 	(2)	2 percent for each of his twenty-first through thirtieth years of employment following his twenty-first birthday; and 

 

	 	(3)	1 percent for each of his thirty-first through fortieth years of employment following his twenty-first birthday; 

provided, however, participants shall receive credit only for those years during which they were between the ages of 21 and 25 which occur
on or after January 1, 1985. 
  

	(b)	Effective from January 1, 1988 until December 31, 1997, in the event a participant completed 40 years of employment after age 21 but before his retirement, no
additional percentages shall be earned in excess of 80 percent, but the maximum percentage shall be applied to the participant’s highest 60 consecutive months average salary derived during his final 120 months of employment prior to his
retirement. 

  

	(c)	With respect to the calculations required by (a) and (b) above, the following limitations shall apply: 

 

	 	(1)	In calculating benefits for those who were employees of Sunset Life Insurance Company of America prior to January 1, 1974 and who were participants under the Prior
Plan on January 1, 1982, such participant’s multiplication factor for any year of participation prior to January 1, 1974 shall be at the rate of 0.5 percent of the first $4,800 of compensation plus 1.5 percent of compensation in
excess of $4,800. These percentages shall be applied to the participant’s compensation at the earlier of— 

  

	 	(A)	the time of termination or retirement; or 

  

	 	(B)	December 31, 1997, 

pursuant to the formula described hereinabove. The applicable factor described in subsection (a) above shall commence with any year
of a participant’s qualification beginning on or after January 1, 1974 and prior to January 1, 1998. 

  
 67 

 
If a participant in the Sunset Plan shall have earned a benefit thereunder that is greater in amount than he shall have earned under this Appendix, he shall be entitled to receive such greater
amount under the conditions of the Sunset Plan in effect prior to January 1, 1982. 
  

	 	(2)	The benefit formula authorized herein shall be based on employment with National Reserve Life Insurance Company commencing on or after January 1, 1982, and the
multiplying factor therefore shall commence at the rate of 2.5 percent per year of employment in accordance with the benefit formula unless prior employment was derived from Kansas City life Insurance Company, Sunset Life Insurance Company of
America, or Armour Life Insurance Company. 

  

	 	(3)	All employment with Armour Life Insurance Company shall be counted using the benefit formula; 

For the purposes herein, a year of employment shall mean each consecutive 12-month period commencing with a participant’s date of
employment and ending on his date of termination or retirement. The percentages above shall be prorated on the basis of twelfths for any final year of employment in which the employee works less than 12 months. 

Notwithstanding anything in the preceding provisions of this Appendix section A.1 to the contrary, if any person who
is an employee of the Company on or after January 1, 1988 shall have two or more periods of participation, then his maximum benefit pursuant to the preceding provisions of this section A. 1 shall be determined by multiplying his total
percentage. derived from his years of employment while a
participant times his highest 60 consecutive months average salary, derived during his most recent 120 months of employment; provided, however, that neither employment nor salary after December 3 1, 1997 shall be considered for this purpose.

  

	(d)	In calculating benefits for those who were participants in the Employees Retirement Plan of Old American Insurance Company on both December 31, 1991 and
January 1, 1992, such participant’s benefits shall be the sum of— 

  

	 	(1)	1.3 percent of the participant’s Plan Compensation in excess of his Social Security Covered Compensation in effect for calendar year 1991, plus 0.5 percent of the
participant’s Plan Compensation in excess of his Social Security Covered Compensation in effect for calendar year 1991, such sum multiplied by his years of creditable service (as of December 31, 1991) and divided by 12. However, in no case
shall this monthly benefit be less than one twelfth of the difference between an amount equal to 2 percent of the participant’s Plan Compensation as of December 31, 1988 multiplied by his years of creditable service as of December 31,
1988, and an amount equal to 60 percent of the participant’s annual primary Social Security determined as if the participant terminated employment on December 31, 1988, multiplied by a fraction the numerator of which is the number of years
of the participant’s creditable service as of December 31, 1988, and the denominator of which is 35; plus 

  
 68 

  

	 	(2)	the benefit earned under the Prior Plan based on employment commencing on or after January 1, 1992 and prior to January 1, 1998, and the multiplying factor
therefor, shall commence at the rate of 2.5 percent per year of employment in accordance with the benefit formula applicable under subsection (a) of this Appendix section A l. This benefit shall be calculated by multiplying such
participant’s highest 60 consecutive months average salary derived during his final 120 months of employment commencing on January 1, 1992 by the multiplying factor; provided, however, that neither employment nor salary after
December 31, 1997 shall be considered for this purpose. 

 The benefit described in (1) above shall be
nonforfeitable. 
  

	(e)	Notwithstanding anything in this Plan to the contrary, a participant’s Prior Plan Benefit, when calculated on the basis of his maximum benefit as a Straight Life
Annuity, shall not exceed 80 percent of his average monthly salary reduced by one-half of his Social Security benefit to which he would be entitled at his Social - Security retirement age, calculated at the time of his actual retirement or
termination based upon his Social Security benefit then earned, and any such benefit shall be further limited as, set forth in section 6.11 of the Plan. 

 A.2 Prior Plan Early Retirement Benefit 
  

	(a)	For those employees becoming participants in the Prior Plan on or after January 1, 1982, retirement shall be permitted at the option of the participant, on or
after his fifty-fifth birthday with benefits payable at the time of actual retirement at such time as the combination of the participant’s age and years of employment following his twenty-fifth birthday equals 75. For purposes of this paragraph
(a), the years of employment with Old American Insurance Company prior to January 1, 1992 of an employee of Old American Insurance Company who became a participant under the Prior Plan on January 1, 1992 shall be included. The calculation
of the benefit to which such a participant under this paragraph is entitled shall be made pursuant to section A.l (d)(2) of this Appendix and subsection (c) below, if applicable. 

 

	(b)	For those employees who have become participants in the Prior Plan prior to January 1, 1982, retirement shall be permitted at the option of the participant, with
full earned benefits payable at the time of actual retirement, after the age of 60 if such participant shall have then completed at least ten years of participation, and retirement shall be permitted at the option of the participant, between the
ages of 55 and 60, with full earned benefits payable at age 60, if such participant shall have then completed at least 15 years of participation. For the purposes of this subsection (b) and of subsection (c) below, any person who was an
employee of Sunset Life Insurance Company of America on December 31, 1981 shall be treated as having become a participant prior to January 1, 1982. 

  
 69 

  

	(c)	If a participant shall be entitled to retire between the ages of 55 and 60 pursuant to either subsection (a) or (b) above, but elects to have his retirement
benefits commence on or after the date of his actual retirement, but prior to his sixtieth birthday, his maximum Straight Life Annuity retirement benefit shall be calculated by reducing his total percentages accumulated pursuant to the formula set
forth hereinabove by units of 15/100 of 1 percent for each month his benefits commence prior to his sixtieth birthday; provided, however, that any such person who commenced his participation in the Prior Plan on or after January 1, 1982 shall
have his maximum Straight Life Annuity retirement benefit actuarially reduced from the amount he would be entitled to receive at age 60 in accordance with the following formula: 

Any benefit which shall be subject to actuarial reduction pursuant to subsections (c) and (d) of this section A.2 shall be
reduced by a percentage determined by multiplying the number of months a participant retires prior to age 60 by a factor of six-tenths of 1 percent. 
  

	(d)	For vested participants whose termination from employment occurs prior to age 55, benefits may be available pursuant to the following: 

 

	 	(1)	For those employees becoming participants in the Prior Plan on or after January 1, 1982, payment of benefits may commence, at the option of said terminated
participant at such time as the combination of the participant’s age and years of employment following his twenty-fifth birthday equals 75, if he shall then be living, but not prior to his age 55, and not later than age 65. If such participant
shall be entitled to receive his benefits prior to age 60, and so elects, such benefit shall be subject to the actuarial reduction required by subsection (c) above. For purposes of this paragraph (1), the years of employment with Old American
Insurance Company prior to January 1, 1992 of an employee of Old American Insurance Company who became a participant in the Prior Plan on January 1, 1992 shall be included. The calculation of the benefit to which such a participant under
this paragraph is entitled shall be made pursuant to section A.1 (d)(2) of this Appendix and subsection (c) above, if applicable. 

  

	 	(2)	For any employee who was a participant in the Prior Plan on December 31, 1981, if such participant has five or more years of Vesting Service and if he shall have
completed ten years of employment with the Company, and if his employment with the Company shall terminate prior to his fifty- fifth birthday for any reason, said employee shall be entitled to receive his earned benefits commencing at his sixtieth
birthday if he shall then be living. Furthermore, if said participant shall have completed 15 years of employment with the Company, said participant may elect to receive such benefits at any time after age 55, but his maximum Straight Life Annuity
retirement benefit shall be calculated by reducing his total percentage accumulated pursuant to the formula set forth herein above by units of 15/100 of 1 percent for each month his benefits commence prior to his sixtieth birthday. For the purposes
of this paragraph (2), any person who was an employee of Sunset Life Insurance Company of America on December 31, 1981 shall be treated as having become a participant prior to January 1, 1982. 

  
 70 

  

	(e)	If a participant is entitled to a benefit under section A. 1(d)(1) of this Appendix, retirement shall be permitted as to that benefit at the option of the participant,
on the last day of the month on or after his fifty-fifth birthday providing he has at least five years of actual service on December 31, 1991. This benefit under section A. 1 (d)(1) of this Appendix, shall be reduced by 1/180 for each of the
first 60 months and 1/360 for each additional month by which such date precedes the later of the participant’s sixty-fifth birthday or the date which is the fifth anniversary of the date he first became a participant in the Employees Retirement
Plan of Old American Insurance Company. If a participant is entitled to a benefit from section A.1(d)(2) under section A.2(a) of this Appendix, that benefit shall be reduced pursuant to section A.2(c) of this Appendix, if applicable.

 A.3 Prior Plan Credit for Disability 
 Any person who, prior to January 1, 1998, qualified to participate in the Prior Plan and who also qualified to receive disability benefits under either the Kansas City Life Disability Plan which was
effective January 1, 1985, or the Sunset Life Long Term Disability Plan, which was effective August 1, 1989, shall be entitled to count the period of time for which disability benefits are received for purposes of calculating retirement
benefits pursuant to the preceding provisions of this Appendix, provided that no more than ten years of such period of disability shall be so counted. The period of active employment immediately preceding the date of disability shall be used in
determining the average monthly salary against which the percentages shall be applied. 
 Notwithstanding anything in the Prior Plan to the
contrary, any such disabled participant shall be required to commence receiving retirement benefits pursuant to the Prior Plan at the later of age 60, or after the completion of ten years as a participant in the Prior Plan, unless such participant
may qualify for a higher retirement benefit because such participant is in the ten-year period of disability. However, benefits pursuant to the Prior Plan must commence no later than the first day of the month following the disabled
participant’s sixty-fifth birthday. 
 Furthermore, the period of disability to be credited hereunder shall not exceed the lesser of ten
years or the number of years during which the participant has been qualified as a participant in the Prior Plan. However, if the disability of the participant receiving disability payments commences on or after November 1, 1996 and the
participant’s employment is terminated for any reason, said disabled participant shall be treated as a terminated participant under the Prior Plan and his pension benefit shall be paid in accordance with the provisions of the Prior Plan. In the
event the disabled participant shall attain the age of 60, at which age he or she becomes vested in a pension benefit hereunder, said disabled participant shall be deemed retired under the provisions of the Prior Plan and shall commence to receive
the earned retirement benefit. In the event the disability payment to which the disabled participant is entitled is greater than the retirement benefit under the Prior Plan, the disabled participant shall continue to receive the disability benefit,
but reduced by the amount of the pension benefit paid under the Prior Plan. No further benefit shall be earned under the Prior Plan by any disabled participant following age 65. However, retirement benefits shall not commence under this section A.3
prior to the participant attaining age 62 unless the participant consents to the commencement of retirement benefits. 

  
 71 

 Such person drawing disability benefits from said disability plan shall not be entitled to count the years
for which disability payments are being made for purposes of determining eligibility for vesting under the Prior Plan. 
 A.4 Prior Plan
Consumer Price Index Benefits 
 In addition to the retirement benefits guaranteed by the preceding provisions of this Appendix, the
following persons shall be entitled to receive annual increases in the amount of their regular retirement benefits commencing with their sixtieth birthday, computed in accordance with section 6.10(a)(1)(F)(i) of the Plan and sections A.1 and A.2 of
this Appendix:. 
  

	(a)	Any person who terminated employment from Kansas City Life Insurance Company prior to January 1982 and who is entitled to receive a retirement benefit pursuant to the
Prior Plan; 

  

	(b)	Any person who was or became a participant in the Prior Plan on or after January 1, 1982 and who shall qualify for retirement benefits under the Prior Plan; and

  

	(c)	Any beneficiary of the above person or persons who shall otherwise be qualified to receive retirement benefits pursuant to the Prior Plan. 

However, a participant or a beneficiary receiving a retirement benefit under section A.l(d)(1) of this Appendix shall not be entitled to receive annual
increases in that retirement benefit under this section A.4. Any regular retirement benefit received by this participant based on employment after December 31, 1991 shall be entitled to receive annual increases under this section A.4.

 Such increases shall also be payable in accordance with the following procedures: 

 

	(1)	Benefits shall be increased on a percentage basis equal to increases reflected in the “Consumer Price Index for U.S. City Average: All Urban Consumers”
prepared by the U.S. Department of Labor, herein sometimes referred to as the “Consumer Price Index.” 

  

	(2)	In the event the Consumer Price Index shall reflect a decrease there shall not be any decrease in benefits provided under the Prior Plan.

  

	(3)	Such percentage increase shall be applied to the monthly income so computed for December of the calendar year just completed. 

 

	(4)	The maximum increase in the percentage rate of benefits shall be 3 percent in each calendar year, or less if the Consumer Price Index shall move less than 3 percent
from year to year. No increase shall be available until the sixtieth birthday of the person eligible to receive such benefit. 

  

	(5)	Any increase in benefits authorized pursuant to this section A.4 shall commence with benefits payable in the month of February following December 31 of the year in
which the last change in the Consumer Price Index was reflected. In the event the Consumer Price Index change shall not be available to the Company in time to effect the commencement of any such increase at the time otherwise required herein, such
increase may be effected by retroactive adjustments at the first advantageous time to the Company. 

  
 72 

  

	(6)	Notwithstanding anything in this section A.4 to the contrary, a participant shall be entitled to any increased benefits pursuant to this section A.4 in the calendar
year immediately following the year in which he retires only if his retirement occurs on or after his normal retirement date. With respect to the participant whose retirement commences prior to his normal retirement date and in the first six-month
period of any calendar year, or whose retirement commences prior to age 60 and whose sixtieth birthday occurs in the first six-month period of any calendar year, any increased benefits payable pursuant to this section A.4 shall commence in the year
immediately following the later of his retirement or sixtieth birthday. If his retirement prior to his normal retirement date or his sixtieth birthday if he retired prior to age 60, occurs in the second six-month period of any calendar year, any
increased benefits payable pursuant to this section A.4 shall commence in the second year after the year of said retirement or sixtieth birthday. 

 A.5 Prior Plan Normal Form of Benefit for Certain Old American Participants 
 The normal
form of the retirement benefit payments to a participant entitled to a benefit under section A.1(d)(1) of this Appendix shall be, as to that benefit, monthly benefit payments for life to the participant with 120 monthly payments guaranteed, as
follows: 
  

	(a)	If the participant dies before receiving 120 monthly payments, the monthly payments shall thereafter be paid to the participant’s beneficiary until an aggregate of
120 monthly payments has been paid to the participant and beneficiary. Any term certain shall not extend beyond the joint life expectancy of the participant and his beneficiary. 

 

	(b)	If the participant dies after his retirement date, and before receiving 120 monthly payments, and is survived by the designated beneficiary, such beneficiary may
request that the actuarial equivalent of the remaining 120 monthly payments be paid to the beneficiary in a lump sum. If this actuarially equivalent lump sum value is not more than $3,500, such lump-sum payment shall be made to the beneficiary
unless the beneficiary is the participant’s spouse, in which event such lump-sum payment shall be made only with the consent of the spouse. 

  

	(c)	If the participant dies after his retirement date without receiving the guaranteed monthly payments, and is not survived by a designated beneficiary, the actuarial
equivalent of the remaining guaranteed monthly payments shall be paid in a lump sum to the participant’s estate. 

  

	(d)	If the beneficiary receiving the guaranteed monthly payments dies before receiving all the guaranteed monthly payments, the actuarial equivalent of the remaining
guaranteed monthly payments shall be paid in a lump sum to the beneficiary’s estate. 

 A.6 Definitions and Construction

  

	(a)	For purposes of this Appendix, the terms listed below shall have the meaning specified below unless the context or the law requires a different interpretation:

  

	 	(1)	“Actual Service” shall mean the aggregate years of service of an employee during all periods of employment by Old American Insurance Company until
December 31, 1991, subject to the provisions of sections 2.2 and 2.3 of the Prior Plan. 

  
 73 

  

	 	(2)	“Creditable Service” shall mean actual service as a participant under the Employees Retirement Plan of Old American Insurance Company starting on the
January 1 (even though the employee may not have been a participant under the Plan at that time) after an employee’s twenty-fifth birthday (if the service is prior to January 1, 1985), or after an employee’s twenty-first birthday
(if the service is after December 31, 1984), and ending December 31, 1991. In no case shall aggregate creditable service for any participant exceed 35 years. 

 

	 	(3)	“Normal Retirement Age” shall mean the later of the participant’s sixtieth birthday, or the date which is the fifth anniversary of the date he
became a participant in the plan. 

  

	 	(4)	“Permanent and Total Disability” shall mean the inability of an employee to perform or resume the regular duties of his employment in a reasonably
efficient manner, in the opinion of the physician selected by the Company, due to a mental or physical condition resulting from a cause which arises after the date of the employment or reemployment of the employee, the physician may review such
evidence as he shall consider pertinent, including but not limited to the opinion of the Company, to arrive at his opinion. 

  

	 	(5)	“Plan Compensation” shall mean average compensation while an employee of Old American Insurance Company (during all periods of employment after the
employee’s eighteenth birthday) for the five consecutive calendar years during the last ten calendar years ending December 31, 1991 which produces the highest average compensation. If a participant has completed less than five years of
service, Plan Compensation shall be the average compensation for his entire period of service. If the employee works a fractional year in the last ten calendar years of participation, the compensation for such fractional year shall be multiplied by
the ratio of 1,000 hours to the number of hours worked in such year, such ratio not being less than one. 

  

	 	(6)	“Primary Social Security” shall mean the estimated primary insurance amount under the Social Security law in effect on December 31, 1991.

  

	 	(7)	“Retirement Date” shall mean the earlier of— 

  

	 	(A)	the last day of the month in which occurs the last day of service of a participant who retires and becomes entitled to benefits; or 

 

	 	(B)	if the participant remains employed after his normal retirement date, the later of his normal retirement date or the last day of the month in which his employment
classification is changed to one in which he is to be credited with less than one thousand hours of service per year. 

  

	 	(8)	“Social Security Covered Compensation” shall have the meaning set forth in Code section 401(1)(5)(E) as in effect on December 31, 1991.

  
 74 

  

	(a)	Unless the context or the law requires a different interpretation, words used in this Appendix and not defined in subsection (a) above shall be construed in
accordance with the Prior Plan. 

  

	(b)	This Appendix is intended to preserve rights and benefits accrued under the Prior Plan on December 31, 1997; it is not intended to create any rights or benefits
for any individual that the individual did not have on December 31, 1997. In the event of any conflict between the provisions of this Appendix and the provisions of the Prior Plan, the provisions of the Prior Plan shall prevail.

  
 75 

 AMENDMENT NUMBER ONE 

TO THE 

KANSAS CITY LIFE INSURANCE COMPANY 
 CASH BALANCE PENSION PLAN 
 AS AMENDED AND RESTATED EFFECTIVE

 JANUARY 1, 2001 
 PREAMBLE 
 Adoption and effective date of amendment. This amendment of the Plan is adopted
to reflect certain provisions of the Economic Growth and Tax Relief Reconciliation Act of 2001 (EGTRRA). This. amendment is intended as good faith compliance with the requirements of EGTRRA and is to be construed in accordance with EGTRRA and
guidance issued thereunder. Except as otherwise provided, this amendment shall be effective as of the first day of the first Plan Year beginning after December 31, 2001. 

Supersession of inconsistent provisions. This amendment shall supersede the provisions of the Plan to the extent those provisions are
inconsistent with the provisions of this amendment. 
 Section 6.11, Maximum Annual Benefits, shall be modified according to the
following: 
  

	 	1.	Effective date. These modifications to Section 6.11 shall be effective for limitation years ending after December 31, 2001. 

 

	 	2.	Effect on participants. Benefit increases resulting from the increase in the limitations of section 415(b) of the Code will be provided to those. Members as specified
by the Company in the Plan document. 

  

	 	3.	Definitions 

  

	 	3.1	Defined benefit dollar limitation. The “defined benefit dollar limitation” is $160,000, as adjusted, effective January 1 of each year, under section
415(d) of the Code in such manner as the Secretary shall prescribe, and payable in the form of a straight life annuity. A limitation as adjusted under section 415(d) will apply to limitation years ending with or within the calendar year for which
the adjustment applies. 

  

	 	3.2	Maximum permissible benefit: The “maximum permissible benefit” is the lesser of the defined benefit dollar limitation or the “defined benefit
compensation limitation” (both adjusted where required, as provided in (a) and, if applicable, in (b) or (c) below). The defined benefit compensation limitation is such Compensation maximum amount that may be taken into account
under the Plan in accordance with Section 2.1(r)(3). 

  
 76 

  

	 	(a)	If the Member has fewer than 10 years of participation in the Plan, the defined benefit dollar limitation shall be multiplied by a fraction, (i) the numerator of
which is the number of years (or part thereof) of participation in the Plan and (ii) the denominator of which is 10. In the case of a participant who has fewer than 10 years of service with the employer, the defined benefit compensation
limitation shall be multiplied by a fraction, (i) the numerator of which is the number of years (or part thereof) of service with the employer and (ii) the denominator of which is 10. 

 

	 	(b)	If the benefit of a Member begins prior to age 62, the defined benefit dollar limitation applicable to the participant at such earlier age is an annual benefit payable
in the form of a straight life annuity beginning at the earlier age that is the actuarial equivalent of the defined benefit dollar limitation applicable to the participant at age 62 (adjusted under (a) above, if required). The defined benefit
dollar limitation applicable at an age prior to age 62 is determined as the lesser of (i) the actuarial equivalent (at such age) of the defined benefit dollar limitation computed using the interest rate and mortality table (or other tabular
factor) specified in Sections 2.1(h) and (i) of the Plan, respectively, and (ii) the actuarial equivalent (at such age) of the defined benefit dollar limitation computed using a 5 percent interest rate and the Applicable Mortality Table as
defined in Section 2.1(i) of the Plan. Any decrease in the defined benefit dollar limitation determined in accordance with this paragraph (b) shall not reflect a mortality decrement if benefits are not forfeited upon the death of the
Member. If any benefits are forfeited upon death, the full mortality decrement is taken into account. 

  

	 	(c)	If the benefit of a Member begins after the Member attains age 65, the defined benefit dollar limitation applicable to the Member at the later age is the annual benefit
payable in the form of a straight life annuity beginning at the later age that is actuarially equivalent to the defined benefit dollar limitation applicable to the Member at age 65 (adjusted under (a) above, if required). The actuarial
equivalent of the defined benefit dollar limitation applicable at an age after age 65 is determined as (i) the lesser of the actuarial equivalent (at such age) of the defined benefit dollar limitation computed using the interest rate and
mortality table (or other tabular factor) specified in Sections 2.1(h) and (i) of the Plan, respectively, and (ii) the actuarial equivalent (at such age) of the defined benefit dollar limitation computed using a 5 percent interest rate
assumption and the Applicable Mortality Table as defined in Section 2.1(i) of the Plan. For these purposes, mortality between age 65 and the age at which benefits commence shall be ignored. 

  
 77 

 Section 2.1(r)(3), the Plan definition of Compensation shall be modified according to the following:

  

	 	1.	Increase in limit. The annual compensation of each Employee taken into account in determining benefit accruals in any Plan Year beginning after December 31, 2001,
shall not exceed $200,000. Annual compensation means compensation during the Plan Year or such other consecutive 12-month period over which compensation is otherwise determined under the Plan (the determination period). For purposes of determining
benefit accruals in a Plan Year beginning after December 31, 2001, the annual compensation limit for any prior determination period shall be limited to $200,000. 

 

	 	2.	Cost-of-living adjustment. The $200,000 limit on annual Compensation in paragraph 1 shall be adjusted for cost-of-living increases in accordance with section
401(a)(17)(B) of the Code. The cost-of-living adjustment in effect for a calendar year applies to annual compensation for the determination period that begins with or within such calendar year. 

Article 18, Top-Heavy Provisions, shall be modified in accordance with the following: 

 

	 	1.	Effective date. These modifications to Article 18 shall apply for purposes of determining whether the Plan is a top-heavy Plan under section 416(g) of the Code for Plan
years beginning after December 31, 2001, and whether the Plan satisfies the minimum benefits requirements of section 416(c) of the Code for such years. The modifications in this paragraph 1 and in paragraphs 2 and 3 amend Article 18 of the
Plan. 

  

	 	2.	Determination of top-heavy status. 

  

	 	2.1	Key Employee. Key Employee means any Employee or former Employee (including any deceased Employee) who at any time during the Plan Year that includes the Determination
Date was an officer of the Employer having annual Compensation greater than $130,000 (as adjusted under section 416(i)(1) of the Code for Plan years beginning after December 31, 2002), a 5-percent owner of the Employer, or a 1-percent owner of
the employer having annual compensation of more than $150,000. For this purpose, annual Compensation means Compensation within the meaning of section 415(c)(3) of the Code. The determination of who is a Key Employee will be made in accordance with
section 416(i)(1) of the Code and the applicable regulations and other guidance of general applicability issued thereunder. 

  

	 	2.2	Determination of present values and amounts. This subparagraph 2.2 shall apply for purposes of determining the present values of accrued benefits and the amounts of
account balances of Members as of the Determination Date. 

  

	 	2.2.1	 Distributions during year ending on the Determination Date. The present values of accrued benefits and the amounts of account balances of a Member as
of the Determination Date shall be increased by the distributions made with respect to the Member under the Plan and any Plan aggregated with the Plan under section 416(g)(2) of the Code during

  
 78 

	 	 
the 1-year period ending on the Determination Date. The preceding sentence shall also apply to distributions under a terminated Plan which, had it not been terminated, would.have been aggregated with the Plan under section 416(g)(2)(A)(i) of the
Code. In the case of a distribution made for a reason other than separation from service, death, or disability, this provision shall be applied by substituting 5-year period for 1-year period. 

 

	 	2.2.2	Employees not performing services during year ending on the Determination Date. The accrued benefits and accounts of any individual who has not performed services for
the employer during the 1-year period ending on the Determination Date shall not be taken into account. 

  

	 	3.	Minimum benefits. For purposes of satisfying the minimum benefit requirements of section 416(c)(1) of the Code and the Plan, in determining years of service with the
Employer, any service with the Employer shall be disregarded to the extent that such service occurs during a Plan Year when the Plan benefits (within the meaning of section 410(b) of the Code) no Key Employee or former Key Employee.

 Section 6.14, Direct Rollover from the Plan, shall be modified in accordance with the following: 

 

	1.	Effective date. These modifications to Section 6.14 shall apply to distributions made after December 31, 2001. 

 

	2.	Modification of definition of eligible retirement Plan. For purposes of the direct rollover provisions in Section 6.14(b)(2) of the Plan, an eligible retirement
Plan shall also mean an annuity contract described in section 403(b) of the Code and an eligible Plan under section 457(b) of the Code which is maintained by a state, political subdivision of a state, or any agency or instrumentality of a state or
political subdivision of a state and which agrees to separately account for amounts transferred into such Plan from this Plan. The definition of eligible retirement Plan shall also apply in the case of a distribution to a surviving spouse, or to a
spouse or former spouse who is the alternate payee under a qualified domestic relation order, as defined in section 414 (p) of the Code. 

  
 79 

 * * * * * * * * * * 
 In Witness Whereof, Kansas City Life Insurance Company has caused this Amendment Number One to the Kansas City Life Insurance Company Cash Balance Pension Plan, as amended and restated effective
January 1, 2001, to be signed and its corporate seal to be hereunto affixed by its duly authorized officers, and Trustees have caused this Amendment Number One to be signed, effective as of January 1, 2002 or such other dates as are set
forth herein or required by law, on this 18 day of December, 2001. 
  

													
		 		 		 		 	Kansas City Life Insurance Company
						
	Attest:	 		 		 		 	By	 	 /s/ J. Todd Salash

							
		 		 		 		 		 	Its	 	         Vice President

						
	By	 	 /s/ Sandra Kowalski
	 		 		 		 	
							
		 	Its	 	 Assistant Secretary
	 		 		 		 	(Corporate Seal)
					
		 		 		 		 	Trustees:
					
		 		 		 		 	 /s/ Richard L. Finn

					
		 		 		 		 	 /s/ John K. Koetting

					
		 		 		 		 	 /s/ Robert C. Miller

  
 80 

 MODEL PLAN AMENDMENT 1 

TO THE 

KANSAS CITY LIFE INSURANCE COMPANY 
 CASH BALANCE PENSION PLAN 
 AS AMENDED AND RESTATED EFFECTIVE

 JANUARY 1, 2001 
 THIS AMENDMENT to the Kansas City Life Insurance Company Cash Balance Pension Plan, reflecting compliance with Revenue Ruling 2001-62 requiring a change in the mortality table used in determining the
limitation on benefits contained in Internal Revenue Code Section 415(b) and the determination of the present value of plan benefits for purposes of Internal Revenue Code Section 417(e), effective the 31st day of December, 2002, is entered into by and between Kansas City
Life Insurance Company, a Corporation organized and existing under the Laws of the State of Missouri, and John K. Koetting, Robert C. Miller and Mark A. Milton, Trustees. 
 Section 1. Effective Date. This amendment shall apply to distributions with annuity starting dates on or after December 31, 2002. 
 Section 2. Notwithstanding any other plan provisions to the contrary, the applicable mortality table used for purposes of adjusting any benefit or limitation under Section 415
(b) (2) (B) , (C) or (D) of the Internal Revenue Code as set forth in Section 6.11 of the Plan and the applicable mortality table used for purposes of satisfying the requirements of Section 417(e) of the Internal
Revenue Code as set forth in Section 2.1(i) of the Plan is the table prescribed in Revenue Ruling 2001-62. 

  
 81 

 IN WITNESS WHEREOF, Kansas City Life Insurance Company has caused this amendment to the
Plan and Trust to be executed by its authorized Officers and its Corporate Seal to be hereunto affixed, and the Trustees have executed the amendment, all on the 17th day of December, 2002. 

 

					
	KANSAS CITY LIFE INSURANCE COMPANY
		
	By:	 	 /s/ J. Todd Salash

	Its:	 	Vice President

  

			
	ATTEST:
		
	By:	 	 /s/ Sherri Morehead

	Its:	 	Assistant Secretary

  

					
	 /s/ John K. Koetting

	
	 /s/ Robert C. Miller

	
	 /s/ Mark A. Milton

	TRUSTEES

  
 82 

 AMENDMENT NUMBER ONE 

TO THE 

KANSAS CITY LIFE INSURANCE COMPANY 
 CASH BALANCE PENSION PLAN 
 AS AMENDED AND RESTATED EFFECTIVE

 JANUARY 1, 2001 
 PREAMBLE 
 Adoption and effective date of amendment. This amendment of the Plan is adopted
to reflect certain provisions of the Economic Growth and Tax Relief Reconciliation Act of 2001 (EGTRRA). This amendment is intended as good faith compliance with the requirements of EGTRRA and is to be construed in accordance with EGTRRA and
guidance issued thereunder. Except as otherwise provided, this amendment shall be effective as of the first day of the first Plan Year beginning after December 31, 2001. 
 Supersession of inconsistent provisions. This amendment shall supersede the provisions of the Plan to the extent those provisions are inconsistent with the provisions of this amendment. 

Section 6.11, Maximum Annual Benefits, shall be modified according to the following: 

 

	 	1.	Effective date. These modifications to Section 6.11 shall be effective for limitation years ending after December 31, 2001. 

 

	 	2.	Effect on participants. Benefit increases resulting from the increase in the limitations of section 415(b) of the Code will be provided to those Members as specified by
the Company in the Plan document. 

  

	 	3.	Definitions. 

  

	 	3.1	Defined benefit dollar limitation. The “defined benefit dollar limitation” is $160,000, as adjusted, effective January 1 of each year, under section
415(d) of the Code in such manner as the Secretary shall prescribe, and payable in the form of a straight life annuity. A limitation as adjusted under section 415(d) will apply to limitation years ending with or within the calendar year for which
the adjustment applies. 

  

	 	3.2	Maximum permissible benefit: The “maximum permissible benefit” is the lesser of the defined benefit dollar limitation or the “defined benefit
compensation limitation” (both adjusted where required, as provided in (a) and, if applicable, in (b) or (c) below). The defined benefit compensation limitation is such Compensation maximum amount that may be taken into account
under the Plan in accordance with Section 2.1(r)(3). 

  
 83 

	 	(a)	If the Member has fewer than 10 years of participation in the Plan, the defined benefit dollar limitation shall be multiplied by a fraction, (i) the numerator of
which is the number of years (or part thereof) of participation in the Plan and (ii) the denominator of which is 10. In the case of a participant who has fewer than 10 years of service with the employer, the defined benefit compensation
limitation shall be multiplied by a fraction, (i) the numerator of which is the number of years (or part thereof) of service with the employer, and (ii) the denominator of which is 10. 

 

	 	(b)	If the benefit of a Member begins prior to age 62, the defined benefit dollar limitation applicable to the participant at such earlier age is an annual benefit payable
in the form of a straight life annuity beginning at the earlier age that is the actuarial equivalent of the defined benefit dollar limitation applicable to the participant at age 62 (adjusted under (a) above, if required). The defined benefit
dollar limitation applicable at an age prior to age 62 is determined as the lesser of (i) the actuarial equivalent (at such age) of the defined benefit dollar limitation computed using the interest rate and mortality table (or other tabular
factor) specified in Sections 2.1(h) and (i) of the Plan, respectively, and (ii) the actuarial equivalent (at such age) of the defined benefit dollar limitation computed using a 5 percent interest rate and the Applicable Mortality Table as
defined in Section 2.1(i) of the Plan. Any decrease in the defined benefit dollar limitation determined in accordance with this paragraph (b) shall not reflect a mortality decrement if benefits are not forfeited upon the death of the
Member. If any benefits are forfeited, upon death, the full mortality decrement is taken into account. 

  

	 	(c)	If the benefit of a Member begins after the Member attains age 65, the defined benefit dollar limitation applicable to the Member at the later age is the annual benefit
payable in the form of a straight life annuity beginning at the later age that is actuarially equivalent to the defined benefit dollar limitation applicable to the Member at age 65 (adjusted under (a) above, if required). The actuarial
equivalent of the defined benefit dollar limitation applicable at an age after age 65 is determined as (i) the lesser of the actuarial equivalent (at such age) of the defined benefit dollar limitation computed using the interest rate and
mortality table (or other tabular factor) specified in Sections 2.1(h) and (i) of the Plan, respectively, and (ii) the actuarial equivalent (at such age) of the defined benefit dollar limitation computed using a 5 percent interest rate
assumption and the Applicable Mortality Table as defined in Section 2.1(i) of the Plan. For these purposes, mortality between age 65 and the age at which benefits commence shall be ignored. 

  
 84 

 Section 2.1(r)(3), the Plan definition of Compensation shall be modified according to the following:

  

	 	1.	Increase in limit. The annual compensation of each Employee taken into account in determining benefit accruals in any Plan Year beginning after December 31, 2001,
shall not exceed $200,000. Annual compensation means compensation during the Plan Year or such other consecutive 12-month period over which compensation is otherwise determined under the Plan (the determination period). For purposes of determining
benefit accruals in a Plan Year beginning after December 31, 2001, the annual compensation limit for any prior determination period shall be limited to $200,000. 

 

	 	2.	Cost-of-living adjustment. The $200,000 limit on annual Compensation in paragraph 1 shall be adjusted for cost-of-living increases in accordance with section
401(a)(17)(B) of the Code. The cost-of-living adjustment in effect for a calendar year applies to annual compensation for the determination period that begins with or within such calendar year. 

Article 18, Top-Heavy Provisions, shall be modified in accordance with the following: 

 

	 	1.	Effective date. These modifications to Article 18 shall apply for purposes of determining whether the Plan is a top-heavy Plan under section 416(g) of the Code for Plan
years beginning after December 31, 2001, and whether the Plan satisfies the minimum benefits requirements of section 416(c) of the Code for such years. The modifications in this paragraph 1 and in paragraphs 2 and 3 amend Article 18 of the
Plan. 

  

	 	2.	Determination of top-heavy status. 

  

	 	2.1	Key Employee. Key Employee means any Employee or former Employee (including any deceased Employee) who at any time during the Plan Year that includes the Determination
Date was an officer of the Employer having annual Compensation greater than $130,000 (as adjusted under section 416(i)(1) of the Code for Plan years beginning after December 31, 2002), a 5-percent owner of the Employer, or a 1-percent owner of
the employer having annual compensation of more than $150,000. For this purpose, annual Compensation means Compensation within the meaning of section 415(c)(3) of the Code. The determination of who is a Key Employee will be made in accordance with
section 416(i)(1) of the Code and the applicable regulations and other guidance of general applicability issued thereunder. 

  

	 	2.2	Determination of present values and amounts. This subparagraph 2.2 shall apply for purposes of determining the present values of accrued benefits and the amounts of
account balances of Members as of the Determination Date. 

  

	 	2.2.1	Distributions during year ending on the Determination Date. The present values of accrued benefits and the amounts of account balances of a Member as of the
Determination Date shall be increased by the distributions made with respect to the Member under the Plan and any Plan aggregated with the Plan under section 416(g)(2) of the Code during the 1-year period ending on the Determination Date. The
preceding sentence shall also apply to distributions under a terminated Plan which, had it not been terminated, would have been aggregated with the Plan under section 416(g)(2)(A)(i) of the Code. In the case of a distribution made for a reason other
than separation from service, death, or disability, this provision shall be applied by substituting 5-year period for 1-year period. 

  
 85 

	 	2.2.2	Employees not performing services during year ending on the Determination Date. The accrued benefits and accounts of any individual who has not performed services for
the employer during the 1-year period ending on the Determination Date shall not be taken into account. 

  

	 	3.	Minimum benefits. For purposes of satisfying the minimum benefit requirements of section 416(c)(1) of the Code and the Plan, in determining years of service with the
Employer, any service with the Employer shall be disregarded to the extent that such service occurs during a Plan Year when the Plan benefits (within the meaning of section 410(b) of the Code) no Key Employee or former Key Employee.

 Section 6.14, Direct Rollover from the Plan, shall be modified in accordance with the following: 

 

	 	1.	Effective date. These modifications to Section 6.14 shall apply to distributions made after December 31, 2001. 

 

	 	2.	Modification of definition of eligible retirement Plan. For purposes of the direct rollover provisions in Section 6.14(b)(2) of the Plan, an eligible retirement
Plan shall also mean an annuity contract described in section 403(b) of the Code and an eligible Plan under section 457(b) of the Code which is maintained by a state, political subdivision of a state, or any agency or instrumentality of a state or
political subdivision of a state and which agrees to separately account for amounts transferred into such Plan from this Plan. The definition of eligible retirement Plan shall also apply in the case of a distribution to a surviving spouse, or to a
spouse or former spouse who is the alternate payee under a qualified domestic relation order, as defined in section 414(p) of the Code. 

 * * * * * * * * * 

  
 86 

 In Witness Whereof, Kansas City Life Insurance Company has caused this Amendment
Number One to the Kansas City Life Insurance Company Cash Balance Pension Plan, as amended and restated effective January 1, 2001, to be signed and its corporate seal to be hereunto affixed by its duly authorized officers, and Trustees have
caused this Amendment Number One to be signed, effective as of January 1, 2002 or such other dates as are set forth herein or required by law, on this 23rd day of September 2008. 

 

	
	Kansas City Life Insurance Company

Attest: 
  

					
	By	 	 /s/ William A. Schalekamp

			
		 	Its	 	 Sr. Vice President

 

											
	By	 	 /s/ Kimberly K. Farrow
	 		 		 	
						
		 	Its	 	 Sr. Assistant Secretary
	 		 		 	(Corporate Seal)

  

	
	Trustees:
	
	 /s/ Mark A. Milton

	
	 /s/ Tracy W. Knapp

	
	 /s/ Charles R. Duffy Jr.

  
 87 

 AMENDMENT NUMBER TWO 

TO THE 

KANSAS CITY LIFE INSURANCE COMPANY CASH BALANCE PENSION PLAN 
 The Kansas City Life Insurance Company Cash Balance Pension Plan is hereby amended in the following respects. Except as otherwise provided, Amendment Number Two shall be effective as of January 1,
1998. This amendment shall supersede the provisions of the Plan to the extent those provisions are inconsistent with the provisions of this amendment. 
  

	 	1.	Article 2.1(i) is amended by deleting in its entirety and replaced with the following paragraph: 

(i) “Applicable Mortality Table” means the prevailing commissioners’ standard table (described in Code section
807(d)(5)(A)) for purposes of Code section 417(e), used to determine reserves for group annuity contracts issued on the date as of which present value is being determined (without regard to any other subparagraph of Code section 807(d)(5)), that is
prescribed by the Commissioner of the Internal Revenue Service in revenue rulings, notices, or other guidance published in the Internal Revenue Bulletin. For distributions made after December 31, 2002 through December 31, 2007, the
Applicable Mortality Table is the mortality table defined in Revenue Ruling 2001-62. 
  

	 	2.	Article 2.1(mm) is amended by deleting in its entirety and replaced with the following paragraph: 

 

	 	(mm)    	“Projected Cash Balance Account” means the Cash Balance Account projected to Normal Retirement Age using the Applicable Interest Rate, but not less
than 5.5%. 

  

	 	3.	Article 5.1(a)(2)(C) is amended by deleting in its entirety and replaced with the following paragraphs: 

 

	 	(C)	who obtains an Hour of Service on or after January 1, 1998, 

 the Member’s Accrued Benefit shall be a monthly amount, payable to the Member on the later of his Normal Retirement Date or (if he has already attained Normal Retirement Age) the first day of the
month following the month in which the Accrued Benefit is determined, and continuing through the last day of the calendar month which includes the date of the Member’s death. 

Such monthly amount shall be determined as the greater of— 

 

	 	(i)	the Member’s Prior Plan Benefit as described in Appendix A, frozen as of December 31, 1997 with respect to future accruals, determined on the basis of the
benefit that the Member would have been entitled to receive on the first day of the month following the later of his Normal Retirement Age or the date on which his Vesting Service terminates. The Member’s Prior Plan Benefit includes an assumed
annual cost-of-living increase equal to 2.75 percent; or 

  

	 	(ii)	the Member’s Cash Balance Account projected (if necessary) to the Member’s Normal Retirement Age, using the Applicable Interest Rate, but not less than 5.5%,
and converted to an equivalent life annuity using the Actuarial Equivalent Assumptions/Factors. 

  

	 	4.	Article 5.1(a)(3)(C) of the Plan is amended by deleting in its entirety and replaced with the following paragraphs: 

 

	 	(C)	who obtains an Hour of Service on or after January 1, 1998, 

 the Member’s Accrued Benefit shall be a monthly amount, payable to the Member on the later of his Normal Retirement Date or (if the Member has already attained Normal Retirement Age) the first day of
the month following the month in which the Accrued Benefit is determined, and continuing through the last day of the calendar month which includes the date of the Member’s death. 

  
 88 

 Such monthly amount shall be determined as the greater of— 

 

	 	(i)	the Member’s Cash Balance Account projected (if necessary) to the Member’s Normal Retirement Age, using the Applicable Interest Rate, hotter less than 5.5%,
and converted to an equivalent life annuity using the Actuarial Equivalent Assumptions/Factors.; or 

  

	 	(ii)	the benefit the Member would have accrued under the accrued benefit formula applicable to him under the Prior Plan as described in Appendix A with continued benefit
accrual to termination of employment. The Member’s accrued benefit includes an assumed annual cost-of-living increase equal to 2.75 percent; or 

  

	 	(iii)	the Member’s Prior Plan Benefit as described in Appendix A, frozen as of December 3 1, 1997 with respect to future accruals, determined on the basis of the
benefit that the Member would have been entitled to receive on the first day of the month following the later of his Normal Retirement Age or the date on which his Vesting Service terminates. The Member’s Prior Plan Benefit includes an assumed
annual cost-of-living increase equal to 2.75 percent. 

  

	 	5.	Article 5.1(a)(4)is amended by deleting in its entirety and replaced with the following paragraph: 

 

	 	(4)	In the case of any Member on or after January 1, 1998 who was not a Participant on December 31, 1997, and who obtains an Hour of Service on or after
January 1, 1998, the Member’s Accrued Benefit shall be a monthly amount, payable to the Member on the later of the Member’s Normal Retirement Date or (if the Member, has already attained Normal Retirement Age) the first day of the
month following the month in which the Accrued Benefit is determined, and continuing through the last day of the calendar month which includes the date of the Member’s death, equal to the Member’s Cash Balance Account projected (if
necessary) to the Member’s Normal Retirement Age, using the Applicable Interest Rate, but not less than 5.5%, and converted to an equivalent life annuity using the Actuarial Equivalent Assumptions/Factors. 

 

	 	6.	Article 5.1(a)(5)is deleted in its entirety 

  

	 	7.	Article 5.1 (c) (1)(C) is deleted in its entirety and replaced with the following: 

 

	 	(C)	Except in the case of pre-1992 accrued benefits under the Prior Plan for Old American Participants, an annual cost-of-living increase equal to 2.75 percent shall be
assumed, based on the following criteria and deferral ages: 

  

			
	 Criteria
	  	Deferral Age
	 Members with 15 or more years of Vesting Service as of December 31, 1997
	  	60
		  	 
		
	 All other Members
	  	65
		  	 

  

	 	8.	Article 5.1 (e) is deleted in its entirety and replaced with the following: 

 

	 	(e)	Transition Credits. For the years 1998, 1999, 2000, 2001, and 2002, the annual pay credit, if any, provided to a Participant pursuant to the table in subsection
(d) above shall be increased— 

 by 50 percent if the Participant had ten or more years of Vesting
Service on December 31, 1997; or 
 by 100 percent if on December 31, 1997 the Participant had 15 or more years of
Vesting Service; 

  
 89 

 provided, however, that the Participant’s Termination of Employment shall end his right
to future transition credits, even if he is subsequently reemployed and again becomes a Participant prior to the end of 2002. 
  

	 	9.	Article 6.1 (b) is deleted in its entirety and replaced with the following: 

(b) Amount. The monthly normal retirement benefit shall be equal to his Accrued Benefit under the Plan calculated as of the date
benefit payments begin. 
 If a Member continues in employment beyond Normal Retirement Age and his normal retirement benefits
commence during such employment as described in section 7.3, his benefit shall be calculated using the Plan formula in effect when his benefit payments begin. 
 In no event will the Normal Retirement Benefit be less than the amount of any annuity benefit payable at any earlier commencement date, as required under section 411(a)(9) of the Internal Revenue Code.

  

	 	10.	Article 6.2(b) is deleted in its entirety and replaced with the following: 

 (b) Amount. A retired Member’s monthly early retirement benefit shall be the greater of— 
  

	 	(1)	the amount described in section 5.1(a)(2)(i), 5.1(a)(3)(ii), or 5.1(a)(3)(c)(iii) (whichever is applicable), reduced in accordance with section 4.1(c), 4.1(d), 4.1(e),
4.1(f), or 22.3 of the Prior Plan (whichever is applicable), as described in section A.2 of the Appendix hereto; or 

  

	 	(2)	the Member’s Accrued Benefit as of the Annuity Starting Date, adjusted for early commencement by applying the Actuarial Equivalent factors.

 For purposes of paragraph (2), actuarial equivalence shall be determined on the basis of the Applicable
Mortality Table and the Applicable Annual Interest Rate. 
 Notwithstanding the preceding provisions of this section 6.2, the
monthly early retirement benefit of an Old American Participant shall be no less than the benefit (if any) he had accrued under section 22.2(a) of the Prior Plan on December 31, 1997, as described in section A.1(d)(1) of the Appendix hereto,
reduced in accordance with the applicable provisions of section 22.3 of the Prior Plan, as described in section A.2(e) of said Appendix. 
  

	 	11.	Article 6.10 (F) is deleted in its entirety and replaced with the following: 

 

	 	F.	the sum of (i) plus (ii), but not less than (iii): 

  

	 	(i)	the Member’s Prior Plan Benefit on December 31, 1997 payable in any of the above forms otherwise available to the Member, other than a lump sum, with annual
cost-of-living increases determined in the manner prescribed in the Prior Plan, as described in section AA of the Appendix hereto, which annuity shall be the Actuarial Equivalent of the Straight Life Annuity; and 

 

	 	(ii)	the Member’s post-1997 cash balance accruals under section 5.1 of this Plan payable in any of the above forms otherwise available to the Member (including a lump
sum) provided, however, that if such accruals are taken in a form other than a lump sum, they shall be paid in the same form in which the Member’s pre-1998 accrued benefit is paid pursuant to (F)(i) above, but without annual cost-of-living
increases. 

  

	 	(iii)	In no event will the benefit payable be less than the actual amount of the benefit accrued as of December 31, 1997, payable under the terms of the Prior Plan.

  
 90 

	 	12.	Article 6.10(a)(1)(A) is deleted in its entirety and replaced with the following: 

 

	 	(A)	lump sum - this is equal to the greater of the Member’s Cash Balance Account or the Actuarial Equivalent of his Accrued Benefit as defined in Article 5. The
portion of the Accrued Benefit attributable to benefits accrued under the Prior Plan, as described in Appendix A, includes an assumed cost-of-living increase equal to 2.75%. 

 

	 	13.	Article 6.10(a)(2)(A) is deleted in its entirety and replaced with the following: 

 

	 	(A)	lump sum - this is equal to the greater of the Member’s Cash Balance Account or the Actuarial Equivalent of his Accrued Benefit as defined in Article 5. The
portion of the Accrued Benefit attributable to benefits accrued under the Prior Plan, as described in Appendix A, includes an assumed cost-of-living increase equal to 2.75%. 

  
 91 

 BOARD OF RESOLUTION TO AMENDMENT 

THE KANSAS CITY LIFE INSURANCE COMPANY 
 CASH BALANCE PENSION PLAN 
 WHEREAS, Kansas City Life Insurance Company (the
“Company”) restated the Kansas City Life Insurance Company Cash Balance Pension Plan (the “Plan”) effective January 1, 1998. 
 WHEREAS, pursuant to Article 15.1 of the Plan, the Board of Directors of the Company may amend the Plan at any time. 
 WHEREAS, the Board of Directors now deems it desirable to amend the Plan. 
 NOW
THEREFORE, BE IT RESOLVED THAT, Amendment Number Two is hereby adopted and shall be effective as of January 1, 1998. This amendment shall supersede the provisions of the Plan to the extent those provisions are inconsistent with the
provisions of this amendment. 
 IN WITNESS WHEREOF, Kansas City Life Insurance Company has caused Amendment Number
Two to be signed and its corporate seal to be hereby affixed by its duly authorized officer and Trustee have caused this amendment to be signed effective as of January 1, 1998, on this 23rd day of September, 2008. 

 

			
	Kansas City Life Insurance Company
	
	By: /s/ William A. Schalekamp
	William A. Schalekamp
	Senior Vice President

  

	
	Attest:
	
	By: /s/ Kimberly K. Farrow
	Kimberly K. Farrow
	Assistant Secretary

  

	
	(Corporate Seal)
	
	Trustees:
	
	/s/ Tracy W. Knapp
	Tracy W. Knapp
	
	/s/ Mark A. Milton
	Mark A. Milton
	
	/s/ Charles R. Duffy
	Charles R. Duffy

  
 92Employee Medical Plan

 Exhibit 10(o) 

 

			
		 	
 

  
 SUMMARY
PLAN DESCRIPTION
  
 Kansas City
Life
 Insurance Company
 Medical Choice Plus
 Traditional Plan

 
 Effective: January 1, 2009

 
 Group Number: 715040

 

 

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 RIGHT HAND PAGE 
 TABLE OF CONTENTS 
  

					
	 Find it fast!
	  			
		
	 •   How to Use This SPD
	  	 	2	  
		
	 •   How the Plan Works
	  	 	9	  
		
	 •   Plan Highlights
	  	 	16	  
		
	 •   Additional Coverage Details
	  	 	24	  
		
	 •   Exclusions
	  	 	53	  
		
	 •   Claims Procedures
	  	 	66	  
		
	 •   Glossary
	  	 	95	  
		
	 SECTION 1 - WELCOME
	  	 	1	  
		
	 SECTION 2 - INTRODUCTION
	  	 	3	  
		
	 Eligibility
	  	 	3	  
		
	 Cost of Coverage
	  	 	6	  
		
	 How to Enroll
	  	 	6	  
		
	 When Coverage Begins
	  	 	6	  
		
	 Changing Your Coverage
	  	 	7	  
		
	 SECTION 3 - HOW THE PLAN WORKS
	  	 	9	  
		
	 Network and Non-Network Benefits
	  	 	9	  
		
	 Eligible Expenses
	  	 	10	  
		
	 Annual Deductible
	  	 	10	  
		
	 Copayment
	  	 	11	  
		
	 Coinsurance
	  	 	11	  
		
	 Out-of-Pocket Maximum
	  	 	11	  
		
	 Lifetime Maximum Benefit
	  	 	12	  
		
	 SECTION 4 - PERSONAL HEALTH SUPPORT
	  	 	13	  
		
	 Requirements for Notifying Personal Health Support
	  	 	14	  
		
	 Special Note Regarding Mental Health and Substance Abuse Services
	  	 	15	  
		
	 Special Note Regarding Medicare
	  	 	15	  
		
	 SECTION 5 - PLAN HIGHLIGHTS
	  	 	16	  

  
  

			
	 I
	  	TABLE OF CONTENTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

					
	 SECTION 6 - ADDITIONAL COVERAGE DETAILS
	  	 	24	  
		
	 Ambulance Services
	  	 	24	  
		
	 Cancer Resource Services (CRS)
	  	 	25	  
		
	 Chiropractic Treatment
	  	 	25	  
		
	 Congenital Heart Disease (CHD) Surgeries
	  	 	25	  
		
	 Dental Services - Accident Only
	  	 	26	  
		
	 Diabetes Services
	  	 	27	  
		
	 Durable Medical Equipment (DME)
	  	 	28	  
		
	 Emergency Health Services - Outpatient
	  	 	29	  
		
	 Home Health Care
	  	 	30	  
		
	 Hospice Care
	  	 	30	  
		
	 Hospital - Inpatient Stay
	  	 	31	  
		
	 Kidney Resource Services (KRS)
	  	 	31	  
		
	 Lab, X-Ray and Diagnostics - Outpatient
	  	 	32	  
		
	 Lab, X-Ray and Major Diagnostics - CT, PET Scans, MRI, MRA and Nuclear Medicine - Outpatient
	  	 	33	  
		
	 Mental Health and Substance Abuse Services - Inpatient and Intermediate
	  	 	33	  
		
	 Mental Health and Substance Abuse Services - Outpatient
	  	 	34	  
		
	 Nutritional Counseling
	  	 	34	  
		
	 Obesity Surgery
	  	 	35	  
		
	 Ostomy Supplies
	  	 	35	  
		
	 Pharmaceutical Products - Outpatient
	  	 	36	  
		
	 Physician Fees for Surgical and Medical Services
	  	 	36	  
		
	 Physician’s Office Services - Sickness and Injury
	  	 	36	  
		
	 Pregnancy - Maternity Services
	  	 	36	  
		
	 Preventive Care Services
	  	 	37	  
		
	 Prosthetic Devices
	  	 	38	  
		
	 Reconstructive Procedures
	  	 	39	  
		
	 Rehabilitation Services - Outpatient Therapy and Chiropractic Treatment
	  	 	40	  
		
	 Scopic Procedures - Outpatient Diagnostic and Therapeutic
	  	 	41	  
		
	 Skilled Nursing Facility/Inpatient Rehabilitation Facility Services
	  	 	41	  
		
	 Surgery - Outpatient
	  	 	42	  
		
	 Therapeutic Treatments - Outpatient
	  	 	43	  

  
  

			
	 II
	  	TABLE OF CONTENTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

					
	 Transplantation Services
	  	 	43	  
		
	 Travel and Lodging
	  	 	44	  
		
	 Urgent Care Center Services
	  	 	45	  
		
	 Vision Examinations
	  	 	45	  
		
	 Wigs
	  	 	46	  
		
	 SECTION 7 - RESOURCES TO HELP YOU STAY HEALTHY
	  	 	47	  
		
	 www.myuhc.com
	  	 	47	  
		
	
Optum®
NurseLineSM
	  	 	49	  
		
	 Live Nurse Chat
	  	 	50	  
		
	 Live Events on www.myuhc.com
	  	 	50	  
		
	 Healthy Pregnancy Program
	  	 	50	  
		
	 Treatment Decision Support
	  	 	51	  
		
	 UnitedHealth PremiumSM Program
	  	 	51	  
		
	 SECTION 8 - EXCLUSIONS: WHAT THE MEDICAL PLAN WILL NOT COVER
	  	 	53	  
		
	 Alternative Treatments
	  	 	53	  
		
	 Dental
	  	 	53	  
		
	 Devices, Appliances and Prosthetics
	  	 	54	  
		
	 Drugs (The exclusions listed below apply to the medical portion of the Plan only. Prescription Drug coverage is excluded under the medical plan
because it is a separate benefit).
	  	 	55	  
		
	 Experimental or Investigational or Unproven Services
	  	 	55	  
		
	 Foot Care
	  	 	55	  
		
	 Medical Supplies and Equipment
	  	 	56	  
		
	 Mental Health/Substance Abuse
	  	 	57	  
		
	 Nutrition
	  	 	58	  
		
	 Personal Care, Comfort or Convenience
	  	 	58	  
		
	 Physical Appearance
	  	 	59	  
		
	 Preexisting Conditions
	  	 	60	  
		
	 Procedures and Treatments
	  	 	60	  
		
	 Providers
	  	 	61	  
		
	 Reproduction
	  	 	62	  
		
	 Services Provided under Another Plan
	  	 	62	  
		
	 Transplants
	  	 	63	  

  
  

			
	 III
	  	TABLE OF CONTENTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

					
	 Travel
	  	 	63	  
		
	 Types of Care
	  	 	63	  
		
	 Vision and Hearing
	  	 	64	  
		
	 All Other Exclusions
	  	 	64	  
		
	 SECTION 9 - CLAIMS PROCEDURES
	  	 	66	  
		
	 Network Benefits
	  	 	66	  
		
	 Non-Network Benefits
	  	 	66	  
		
	 If Your Provider Does Not File Your Claim
	  	 	66	  
		
	 Health Statements
	  	 	67	  
		
	 Explanation of Benefits (EOB)
	  	 	67	  
		
	 Claim Denials and Appeals
	  	 	68	  
		
	 Limitation of Action
	  	 	72	  
		
	 SECTION 10 - COORDINATION OF BENEFITS (COB)
	  	 	73	  
		
	 Determining Which Plan is Primary
	  	 	73	  
		
	 When This Plan is Secondary
	  	 	74	  
		
	 When a Covered Person Qualifies for Medicare
	  	 	75	  
		
	 Medicare Cross-Over Program
	  	 	75	  
		
	 Right to Receive and Release Needed Information
	  	 	76	  
		
	 Overpayment and Underpayment of Benefits
	  	 	76	  
		
	 SECTION 11 - SUBROGATION AND REIMBURSEMENT
	  	 	78	  
		
	 Right of Recovery
	  	 	78	  
		
	 Right to Subrogation
	  	 	78	  
		
	 Right to Reimbursement
	  	 	79	  
		
	 Third Parties
	  	 	79	  
		
	 Subrogation and Reimbursement Provisions
	  	 	79	  
		
	 SECTION 12 - WHEN COVERAGE ENDS
	  	 	81	  
		
	 Other Events Ending Your Coverage
	  	 	82	  
		
	 Coverage for a Disabled Child
	  	 	82	  
		
	 Continuing Coverage Through COBRA
	  	 	83	  
		
	 When COBRA Ends
	  	 	87	  
		
	 Uniformed Services Employment and Reemployment Rights Act
	  	 	87	  

  
  

			
	 IV
	  	TABLE OF CONTENTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

					
	 SECTION 13 - OTHER IMPORTANT INFORMATION
	  	 	89	  
		
	 Qualified Medical Child Support Orders (QMCSOs)
	  	 	89	  
		
	 Your Relationship with UnitedHealthcare and Kansas City Life Insurance Company
	  	 	89	  
		
	 Relationship with Providers
	  	 	90	  
		
	 Your Relationship with Providers
	  	 	91	  
		
	 Interpretation of Benefits
	  	 	91	  
		
	 Information and Records
	  	 	91	  
		
	 Incentives to Providers
	  	 	92	  
		
	 Incentives to You
	  	 	93	  
		
	 Rebates and Other Payments
	  	 	93	  
		
	 Workers’ Compensation Not Affected
	  	 	93	  
		
	 Future of the Plan
	  	 	93	  
		
	 Plan Document
	  	 	94	  
		
	 SECTION 14 - GLOSSARY
	  	 	95	  
		
	 SECTION 15 - IMPORTANT ADMINISTRATIVE INFORMATION: ERISA
	  	 	110	  

  
  

			
	 V
	  	TABLE OF CONTENTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 1 - WELCOME 
 Quick Reference Box 
  

	•	 	 Member services, claim inquiries, Personal Health Support and Mental Health/Substance Abuse Administrator: (888) 567-4659;

  

	•	 	 Claims submittal address: UnitedHealthcare - Claims, P.O. Box 30555, Salt Lake City, Utah 84130-0555; and 

 

	•	 	 Online assistance: www.myuhc.com. 

 Kansas City Life Insurance Company is pleased to provide you with this Summary Plan Description (SPD), which describes the health Benefits available to you and your covered family members under the Kansas
City Life Employee Medical Plan. It includes summaries of: 
  

	•	 	 who is eligible; 

  

	•	 	 services that are covered, called Covered Health Services; 

 

	•	 	 services that are not covered, called Exclusions; 

  

	•	 	 how Benefits are paid; and 

  

	•	 	 your rights and responsibilities under the Plan. 

 This SPD is designed to meet your information needs and the disclosure requirements of the Employee Retirement Income Security Act of 1974 (ERISA). It supersedes any previous printed or electronic SPD for
this Plan. 
 Kansas City Life Insurance Company intends to continue this Plan, but reserves the right, in its sole discretion, to modify,
change, revise, amend or terminate the Plan at any time, for any reason, and without prior notice. This SPD is not to be construed as a contract of or for employment. If there should be an inconsistency between the contents of this summary and the
contents of the Plan, your rights shall be determined under the Plan and not under this summary. 
 UnitedHealthcare is a private healthcare
claims administrator. UnitedHealthcare’s goal is to give you the tools you need to make wise healthcare decisions. UnitedHealthcare also helps your employer to administer claims. Although UnitedHealthcare will assist you in many ways, it does
not guarantee any Benefits. Kansas City Life Insurance Company is solely responsible for paying Benefits described in this SPD. 
 Please read
this SPD thoroughly to learn how the Kansas City Life Employee Medical Plan works. If you have questions contact your local Human Resources department or call the number on the back of your ID card. 

  
  

			
	 1
	  	SECTION 1 - WELCOME

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 How To Use This SPD 

 

	•	 	 Read the entire SPD, and share it with your family. Then keep it in a safe place for future reference. 

 

	•	 	 Many of the sections of this SPD are related to other sections. You may not have all the information you need by reading just one section.

  

	•	 	 You can request printed copies of your SPD by contacting Human Resources. 

 

	•	 	 Capitalized words in the SPD have special meanings and are defined in Section 14, Glossary. 

 

	•	 	 If eligible for coverage, the words “you” and “your” refer to Covered Persons as defined in Section 14, Glossary.

  

	•	 	 Kansas City Life Insurance Company is also referred to as Company. 

 

	•	 	 If there is a conflict between this SPD and any benefit summaries (other than Summaries of Material Modifications) provided to you, this SPD will
control. 

  
  

			
	 2
	  	SECTION 1 - WELCOME

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 2 - INTRODUCTION 
 What this section includes: 
  

	•	 	 Who’s eligible for coverage under the Plan; 

  

	•	 	 The factors that impact your cost for coverage; 

  

	•	 	 Instructions and timeframes for enrolling yourself and your eligible Dependents; 

 

	•	 	 When coverage begins; and 

  

	•	 	 When you can make coverage changes under the Plan. 

 Eligibility 
 You are eligible to enroll in the Plan if you are regularly scheduled to work
full-time or are designated full-time by the Board of Directors. 
 You are also eligible to enroll in the Plan if you satisfy retiree
eligibility requirements. 
 Your eligible Dependents may also participate in the Plan. An eligible Dependent is considered to be: 

 

	•	 	 your Spouse, as defined in Section 14, Glossary; 

 

	•	 	 your or your Spouse’s unmarried child who is under age 19, including a natural child, stepchild, a legally adopted child, a child placed for
adoption or a child for whom you or your Spouse are the legal guardian; 

  

	•	 	 an unmarried child of any age who is or becomes disabled and dependent upon you; or 

 

	•	 	 your unmarried child age 19 but under age 25 who is: 

  

	 	•	 	 a Full-time Student, as defined in Section 14, Glossary; 

 

	 	•	 	 not regularly employed on a full-time basis; and 

  

	 	•	 	 Primarily dependent on you for support and maintenance. 

 To be eligible for coverage under the Plan, a Dependent must reside within the United States. 

Note: Your Dependents may not enroll in the Plan unless you are also enrolled. If you and your Spouse are both covered under the Kansas
City Company Employee Medical Plan, you may each be enrolled as a Participant or be covered as a Dependent of the other person, but not both. In addition, if you and your Spouse are both covered under the Kansas City Life Employee Medical Plan, only
one parent may enroll your child as a Dependent. 
 A Dependent also includes a child for whom health care coverage is required through a
Qualified Medical Child Support Order or other court or administrative order, as described in Section 13, Other Important Information. 

  
  

			
	 3
	  	SECTION 2 - INTRODUCTION

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 RETIREE ELIGIBILITY 
 Retired employees who satisfy eligibility requirements may continue coverage by paying the applicable premium for Medical Benefits. Retired employees, dependents and surviving spouses who are
eligible for Medicare are not eligible to continue coverage under this plan for the Prescription Drug Program. This includes: 
 Eligible Kansas
City Life Insurance Company Retirees. 
 While the employer expects retiree coverage to continue, the employer reserves the right to modify or
discontinue retiree coverage at any time. 
 Retiree Coverage – Medical 
 Retirees and surviving spouses currently eligible for this medical plan coverage must participate in the medical plan on an on-going basis to be eligible for the plan in the future. The specific
dependents enrolled in the plan will be the only dependents that the retiree or surviving spouse will be eligible to enroll in the future, providing that they meet the plan criteria for participation, except as specified herein. Additional newly
acquired dependents may not be added to the plan in the future. Coverage may be decreased at any time, but once decreased may not be increased at a later date. If the retiree or surviving spouse declines medical coverage, the retiree or surviving
spouse will not be eligible to participate in the medical plan in the future. 
 A dependent covered by the medical Plan who may become a
surviving spouse of a deceased retiree may continue to participate in the plan as long as the surviving spouse participates on an on-going basis. Surviving spouses may not add additional dependents to their coverage. Surviving spouses who
decline coverage in the medical plan will not be eligible to enroll in the future. If the surviving spouse does not elect to continue coverage, or if there is no spouse, all dependents will be offered coverage under the provisions of COBRA.

 Active Employees Who Become Eligible To Retire In The Future – Medical 
 Employees Hired On or After 1/1/2005 Who Become Eligible To Retire In The Future – Employees hired or rehired on or after 1/1/2005 are not eligible to participate in the medical plan when they
retire. 
 Employees Hired On or After 1/1/2000 but prior to 1/1/2005 Who Become Eligible To Retire In The Future – Active employees hired
on or after 1/1/2000 but prior to 1/1/2005 who become eligible to retire in the future must have a minimum of one hundred twenty (120) months of service and continuously participate in the medical plan during the last sixty (60) months of
employment immediately prior to retirement to be eligible for retiree medical plan coverage. The specific dependents enrolled in the plan at the most recent enrollment prior to retirement will be the only dependents the retiree will be eligible to
enroll in the future, except as specified herein. Additional newly acquired dependents may not be added to the plan in the future. 
 Employees
Hired Prior to 1/1/2000 Who Become Eligible To Retire In The Future – Active employees hired prior to 1/1/2000 who become eligible to retire in the future must continuously participate in the medical plan during the last sixty (60) months
of employment immediately prior to retirement to be eligible for retiree medical plan coverage. The specific 

  
  

			
	 4
	  	SECTION 2 - INTRODUCTION

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 
dependents enrolled in the plan at the most recent enrollment prior to retirement will be the only dependents the retiree will be eligible to enroll in the future, except as specified herein.
Additional newly acquired dependents may not be added to the plan in the future. 
 SURVIVING SPOUSE ELIGIBILITY 

Surviving Spouses of Active Employees – Medical 
 Surviving Spouses of Active Employees Hired On or After 1/1/2005 – In the event of the death of an active employee who is hired on or after 1/1/2005, the surviving spouse will be offered medical plan
coverage under the provisions of COBRA. 
 Surviving Spouses of Employees Hired On or After 1/1/2000 but Prior to 1/1/2005 – In the event
of the death of an active employee hired on or after 1/1/2000, the surviving spouse may continue medical plan coverage provided the employee had a minimum of one hundred and twenty (120) months of service and continuously participated in the
plan(s) during the sixty (60) consecutive months immediately preceding the death of the employee. In no event can the surviving spouse obtain coverage unless the spouse was covered as a dependent at the time of the employee’s death, except
as a specified herein. If other dependents were covered at the time of the employee’s death and the surviving spouse qualifies and elects to continue coverage, the other dependents can continue to participate in the plan. 

Surviving Spouses of Employees Hired Prior to 1/1/2000 – In the event of the death of an active employee hired prior to 1/1/2000, the surviving
spouse may continue his or her medical plan coverage provided the employee continuously participated in the plan(s) sixty (60) consecutive months immediately preceding the death of the employee. In no event can the surviving spouse obtain
coverage unless the spouse was covered as a dependent at the tune if the employee’s death, except as specified herein. If other dependents were covered at the time of the employee’s death and the surviving spouse qualifies and elects to
continue coverage, the other dependents can continue to participate in the plan. 
 If the surviving spouse does not meet the above criteria,
but is a dependent covered by the medical plan when the death of the employee occurs, the surviving spouse will be offered coverage under the provisions of COBRA. If the surviving spouse does not qualify or elect to continue coverage, or if there is
no spouse, all dependents will be offered coverage under the provisions of COBRA. 
 When Both Spouses Are Covered By This Plan As The Result
of Current or Past Employment With The Employer 
 If, within a family, both spouses have or have had an employee/employer relationship with
the employer, and are covered under this plan as an employee, dependent or, retiree, and meet the eligibility criteria for retiree medical coverage, such spouse may elect to change his or her coverage options or those of his or her dependents who
are currently covered under the plan in the event that coverage for the other spouse terminates or one of the spouses experiences a status change, i.e., active to retiree. In this instance, the change of coverage options must be made within thirty
(30) days of the status change or termination of one spouse’s coverage. 

  
  

			
	 5
	  	SECTION 2 - INTRODUCTION

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Contribution For Surviving Dependents 
 To continue coverage, surviving dependents of a deceased active or retired employee must apply for coverage within thirty (30) days of that person’s death. The dependents must make any and all
payments required on their behalf. Dependent children may be covered until they no longer qualify as a dependent as defined in this plan. 

Cost of Coverage 
 You and Kansas City
Life Insurance Company share in the cost of the Plan. Your contribution amount depends on the Plan you select and the family members you choose to enroll. 
 Your contributions are deducted from your paychecks on a before-tax basis. Before-tax dollars come out of your pay before federal income and Social Security taxes are withheld - and in most states, before
state and local taxes are withheld. This gives your contributions a special tax advantage and lowers the actual cost to you. 
 Your
contributions are subject to review and Kansas City Life Insurance Company reserves the right to change your contribution amount from time to time. 
 You can obtain current contribution rates by calling Human Resources. 
 How to Enroll

 To enroll, call Human Resources, within 31 days of the date you first become eligible for medical Plan coverage. If you do not enroll
within 31 days, you will need to wait until the next annual Open Enrollment to make your benefit elections. 
 Each year during annual Open
Enrollment, you have the opportunity to review and change your medical election. Any changes you make during Open Enrollment will become effective the following January 1. 
 Important 
 If you wish to change your benefit elections following your marriage, birth or
adoption of a child, or other family status change, you must contact Human Resources within 31 days of the event. Otherwise, you will need to wait until the next annual Open Enrollment to change your elections. 

When Coverage Begins 
 Once Human
Resources receives your properly completed enrollment, coverage will begin on the first day of the month following your date of hire. Coverage for Late Enrollees will begin on the date identified by Kansas City Life Insurance Company after Kansas
City Life Insurance Company receives the completed enrollment form and any required contribution for coverage. Coverage for your Dependents will start on the date your coverage begins, provided you have enrolled them in a timely manner. 

  
  

			
	 6
	  	SECTION 2 - INTRODUCTION

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Coverage for a Spouse or Dependent stepchild that you acquire via marriage becomes effective the first
of the month following the date Human Resources receives notice of your marriage, provided you notify Human Resources within 31 days of your marriage. Coverage for Dependent children acquired through birth, adoption, or placement for adoption is
effective the date of the family status change, provided you notify Human Resources within 31 days of the birth, adoption, or placement. 

Changing Your Coverage 
 You may make
coverage changes during the year only if you experience a change in family status. The change in coverage must be consistent with the change in status (e.g., you cover your Spouse following your marriage, your child following an adoption, etc.). The
following are considered family status changes for purposes of the Plan: 
  

	•	 	 your marriage, divorce, legal separation or annulment; 

 

	•	 	 the birth, adoption or legal guardianship of a child; 

 

	•	 	 a change in your Spouse’s employment or involuntary loss of health coverage (other than coverage under the Medicare or Medicaid programs) under
another employer’s plan; 

  

	•	 	 loss of coverage due to the exhaustion of another employer’s COBRA benefits, provided you were paying for premiums on a timely basis;

  

	•	 	 the death of a Dependent; 

  

	•	 	 your Dependent child no longer qualifying as an eligible Dependent; 

 

	•	 	 a change in your or your Spouse’s position or work schedule that impacts eligibility for health coverage; 

 

	•	 	 contributions were no longer paid by the employer (This is true even if you or your eligible Dependent continues to receive coverage under the prior
plan and to pay the amounts previously paid by the employer); 

  

	•	 	 you or your eligible Dependent who were enrolled in an HMO no longer live or work in that HMO’s service area and no other benefit option is
available to you or your eligible Dependent; 

  

	•	 	 benefits are no longer offered by the Plan to a class of individuals that include you or your eligible Dependent; 

 

	•	 	 you or your eligible Dependent incurs a claim that would exceed a lifetime limit on all benefits under the elected health care option through Kansas
City Life Insurance Company; 

  

	•	 	 A significant change in the medical benefits or health insurance coverage of the participant or the participant’s spouse under the spouse’s
employer’s health plan; 

  

	•	 	 a strike or lockout involving you or your Spouse; or 

  

	•	 	 a court or administrative order. 

  
  

			
	 7
	  	SECTION 2 - INTRODUCTION

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 If you wish to change your elections, you must contact Human Resources within 31 days of the change in
family status. Otherwise, you will need to wait until the next annual Open Enrollment. 
 While some of these changes in status are similar to
qualifying events under COBRA, you, or your eligible Dependent, do not need to elect COBRA continuation coverage to take advantage of the special enrollment rights listed above. These will also be available to you or your eligible Dependent if COBRA
is elected. 
 Note: Any child under age 19 who is placed with you for adoption will be eligible for coverage on the date
the child is placed with you, even if the legal adoption is not yet final. If you do not legally adopt the child, all medical Plan coverage for the child will end when the placement ends. No provision will be made for continuing coverage (such as
COBRA coverage) for the child. 
 Change in Family Status - Example 
 Jane is married and has two children who qualify as Dependents. At annual Open Enrollment, she elects not to participate in Kansas City Life Insurance Company’s medical plan, because her husband,
Tom, has family coverage under his employer’s medical plan. In June, Tom loses his job as part of a downsizing. As a result, Tom loses his eligibility for medical coverage. Due to this family status change, Jane can elect family medical
coverage under Kansas City Life Insurance Company’s medical plan outside of annual Open Enrollment. 

  
  

			
	 8
	  	SECTION 2 - INTRODUCTION

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 3 - HOW THE PLAN WORKS 
 What this section includes: 
  

	•	 	 Network and Non-Network Benefits; 

  

	•	 	 Eligible Expenses; 

  

	•	 	 Annual Deductible; 

  

	•	 	 Copayment; 

  

	•	 	 Out-of-Pocket Maximum; 

  

	•	 	 Lifetime Maximum Benefit; and 

  

	•	 	 Coinsurance. 

 Network
and Non-Network Benefits 
 As a participant in this Plan, you have the freedom to choose the Physician or health care professional you
prefer each time you need to receive Covered Health Services. The choices you make affect the amounts you pay, as well as the level of Benefits you receive and any benefit limitations that may apply. 

You are eligible for the Network level of Benefits under this Plan when you receive Covered Health Services from Physicians and other health care
professionals who have contracted with UnitedHealthcare to provide those services. For facility services, these are Benefits for Covered Health Services that are provided at a Network facility. Emergency Health Services, including the services of
either a Network or non-Network Emergency room Physician, are always paid as Network Benefits. Covered Health Services provided in a Network facility by a non-Network consulting Physician, anesthesiologist, pathologist and radiologist will be paid
as Non-Network Benefits. 
 Certain Physicians and providers have been identified as a Designated Facility or Physician. Designated Network
Benefits apply to Covered Health Services that are provided by a Network Physician or other provider that is identified as a Designated Facility or Physician. Designated Network Benefits are available only for specific Covered Health Services as
identified in Section 5, Plan Highlights. 
 Generally, when you receive Covered Health Services from a Network provider, you pay
less than you would if you receive the same care from a non-Network provider. Therefore, in most instances, your out-of-pocket expenses will be less if you use a Network provider. 
 If you choose to seek care outside the Network, the Plan generally pays Benefits at a lower level. You are required to pay the amount that exceeds the Eligible Expense. The amount in excess of the
Eligible Expense could be significant, and this amount does not apply to the Out-of-Pocket Maximum. You may want to ask the non-Network provider about their billed charges before you receive care. Emergency services received at a non-Network
Hospital are covered at the Network level. 

  
  

			
	 9
	  	SECTION 4 - PERSONAL HEALTH SUPPORT

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Looking for a Network Provider? 
 In addition to other helpful information, www.myuhc.com, UnitedHealthcare’s consumer website, contains a directory of health care professionals and facilities in UnitedHealthcare’s
Network. While Network status may change from time to time, www.myuhc.com has the most current source of Network information. Use www.myuhc.com to search for Physicians available in your Plan. 

Network Providers 

UnitedHealthcare or its affiliates arrange for health care providers to participate in a Network. At your request, UnitedHealthcare will send you a
directory of Network providers free of charge. Keep in mind, a provider’s Network status may change. To verify a provider’s status or request a provider directory, you can call UnitedHealthcare at the toll-free number on your ID card or
log onto www.myuhc.com. 
 Network providers are independent practitioners and are not employees of Kansas City Life Insurance Company or
UnitedHealthcare. 
 Possible Limitations on Provider Use 
 If UnitedHealthcare determines that you are using health care services in a harmful or abusive manner, you may be required to select a Network Physician to coordinate all of your future Covered Health
Services. If you don’t make a selection within 31 days of the date you are notified, UnitedHealthcare will select a Network Physician for you. In the event that you do not use the Network Physician to coordinate all of your care, any Covered
Health Services you receive will be paid at the non-Network level. 
 Eligible Expenses 

Eligible Expenses are charges for Covered Health Services that are provided while the Plan is in effect, determined according to the definition in
Section 14, Glossary. For certain Covered Health Services, the Plan will not pay these expenses until you have met your Annual Deductible. Kansas City Life Insurance Company has delegated to UnitedHealthcare the initial discretion and
authority to decide whether a treatment or supply is a Covered Health Service and how the Eligible Expenses will be determined and otherwise covered under the Plan. 
 Don’t Forget Your ID Card 
 Remember to show your UnitedHealthcare ID card every time
you receive health care services from a provider. If you do not show your ID card, a provider has no way of knowing that you are enrolled under the Plan. 
 Annual Deductible 
 The Annual Deductible is the amount of Eligible Expenses you must pay
each calendar year for Covered Health Services before you are eligible to begin receiving Benefits. There are separate Network and non-Network Annual Deductibles for this Plan. The amounts you pay toward your Annual Deductible accumulate over the
course of the calendar year. 

  
  

			
	 10
	  	SECTION 4 - PERSONAL HEALTH SUPPORT

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Amounts paid toward the Annual Deductible for Covered Health Services that are subject to a visit or day
limit will also be calculated against that maximum benefit limit. As a result, the limited benefit will be reduced by the number of days or visits you used toward meeting the Annual Deductible. 

Copayment 
 A Copayment (Copay) is the
amount you pay each time you receive certain Covered Health Services. The Copay is a flat dollar amount and is paid at the time of service or when billed by the provider. Copays do not count toward the Out-of-Pocket-Maximum. Copays do not count
toward the Annual Deductible. If the Eligible Expense is less than the Copay, you are only responsible for paying the Eligible Expense and not the Copay. 
 Coinsurance 
 Coinsurance is the percentage of Eligible Expenses that you are responsible
for paying. Coinsurance is a fixed percentage that applies to certain Covered Health Services after you meet the Annual Deductible. 

Coinsurance – Example 
 Let’s
assume that you receive Plan Benefits for outpatient surgery from a Network provider. Since the Plan pays 90% after you meet the Annual Deductible, you are responsible for paying the other 10%. This 10% is your Coinsurance. 

Out-of-Pocket Maximum 
 The annual
Out-of-Pocket Maximum is the most you pay each calendar year for Covered Health Services. There is a separate Out-of-Pocket Maximum for Network and Non-Network Benefits. If your eligible out-of-pocket expenses in a calendar year exceed the annual
maximum, the Plan pays 100% of Eligible Expenses for Covered Health Services through the end of the calendar year. 
 The following table
identifies what does and does not apply toward your Out-of-Pocket Maximum: 
  

			
	Plan Features	  	  

Applies to the Out-
 of-Pocket Maximum?
  

	  

Copays
  
	  	No
 

	  

Payments toward the Annual Deductible

 
	  	Yes
 

	  

Coinsurance Payments
  
	  	Yes
 

	  

Charges for non-Covered Health Services

 
	  	No
 

	  

The amounts of any reductions in Benefits you incur by not notifying Personal Health Support

 
	  	No
 

	  

Charges that exceed Eligible Expenses

 
	  	No
 

  
  

			
	 11
	  	SECTION 4 - PERSONAL HEALTH SUPPORT

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Lifetime Maximum Benefit 
 The Lifetime Maximum Benefit is the most the Plan will pay for Benefits during the entire period you are enrolled under this Plan offered by Kansas City Life Insurance Company. There are combined Network
and non-Network Lifetime Maximum Benefits for this Plan. 

  
  

			
	 12
	  	SECTION 4 - PERSONAL HEALTH SUPPORT

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 4 - PERSONAL HEALTH SUPPORT 
 What this section includes: 
  

	•	 	 An overview of the Personal Health Support program; and 

 

	•	 	 Covered Health Services for which you need to contact Personal Health Support. 

UnitedHealthcare provides a program called Personal Health Support designed to encourage personalized, efficient care for you and your covered
Dependents. 
 Personal Health Support Nurses center their efforts on prevention, education, and closing any gaps in your care. The goal of the
program is to ensure you receive the most appropriate and cost-effective services available. A Personal Health Support Nurse is notified when you or your provider calls the toll-free number on your ID card regarding an upcoming treatment or service.

 If you are living with a chronic condition or dealing with complex health care needs, UnitedHealthcare may assign to you a primary nurse,
referred to as a Personal Health Support Nurse to guide you through your treatment. This assigned nurse will answer questions, explain options, identify your needs, and may refer you to specialized care programs. The Personal Health Support Nurse
will provide you with their telephone number so you can call them with questions about your conditions, or your overall health and well-being. 

Personal Health Support Nurses will provide a variety of different services to help you and your covered family members receive appropriate medical care.
Program components and notification requirements are subject to change without notice. As of the publication of this SPD, the Personal Health Support program includes: 
  

	•	 	 Admission counseling - For upcoming inpatient Hospital admissions for certain conditions, a Treatment Decision Support Nurse may call you to
help answer your questions and to make sure you have the information and support you need for a successful recovery. 

  

	•	 	 Inpatient care advocacy - If you are hospitalized, a nurse will work with your Physician to make sure you are getting the care you need and that
your Physician’s treatment plan is being carried out effectively. 

  

	•	 	 Readmission Management - This program serves as a bridge between the Hospital and your home if you are at high risk of being readmitted. After
leaving the Hospital, if you have a certain chronic or complex condition, you may receive a phone call from a Personal Health Support Nurse to confirm that medications, needed equipment, or follow-up services are in place. The Personal Health
Support Nurse will also share important health care information, reiterate and reinforce discharge instructions, and support a safe transition home. 

  

	•	 	 Risk Management - Designed for participants with certain chronic or complex conditions, this program addresses such health care needs as access
to medical 

  
  

			
	 13
	  	SECTION 4 - PERSONAL HEALTH SUPPORT

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

	 	 
specialists, medication information, and coordination of equipment and supplies. Participants may receive a phone call from a Personal Health Support Nurse to discuss and share important health
care information related to the participant’s specific chronic or complex condition. 

 If you do not receive a call from
a Personal Health Support Nurse but feel you could benefit from any of these programs, please call the toll-free number on your ID card. 

Requirements for Notifying Personal Health Support 
 There are some Network Benefits for which you are responsible for notifying Personal Health Support. However, Network providers are generally responsible for notifying Personal Health Support before they
provide these services to you. 
 When you choose to receive certain Covered Health Services from non-Network providers, you are responsible for
notifying Personal Health Support before you receive these Covered Health Services. In many cases, your Non-Network Benefits will be reduced if Personal Health Support is not notified. 
 The services that require Personal Health Support notification are: 
  

	•	 	 ambulance – non-emergent air and ground; 

  

	•	 	 Congenital Heart Disease services; 

  

	•	 	 dental services - accident only; 

  

	•	 	 Durable Medical Equipment for items that will cost more than $1,000 to purchase or rent; 

 

	•	 	 home health care; 

  

	•	 	 hospice care - inpatient; 

  

	•	 	 Hospital Inpatient Stay, including Emergency admission; 

 

	•	 	 maternity care that exceeds the delivery timeframes as described in Section 6, Additional Coverage Details;

  

	•	 	 obesity surgery; 

  

	•	 	 outpatient therapeutics – dialysis; 

  

	•	 	 Reconstructive Procedures; 

  

	•	 	 Skilled Nursing Facility/Inpatient Rehabilitation Facility Services; and 

 

	•	 	 transplantation services. 

For notification timeframes, and reductions in Benefits that apply if you do not notify Personal Health Support, see Section 6, Additional
Coverage Details. 
 Contacting Personal Health Support is easy. 
 Simply call the toll-free number on your ID card. 

  
  

			
	 14
	  	SECTION 4 - PERSONAL HEALTH SUPPORT

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Special Note Regarding Mental Health and Substance Abuse Services 

For inpatient, intermediate or outpatient Mental Health/Substance Abuse (MH/SA) Services, you are responsible for calling the MH/SA Administrator in
advance of any service to get authorization to receive these Benefits. Without prior authorization, you will be responsible for paying all charges and no Benefits will be paid. The MH/SA Administrator’s phone number appears on your ID card.

 Special Note Regarding Medicare 
 If you are enrolled in Medicare and Medicare pays benefits before the Plan, you are not required to notify Personal Health Support before receiving Covered Health Services. Since Medicare pays benefits
first, the Plan will pay Benefits second as described in Section 10, Coordination of Benefits (COB). 

  
  

			
	 15
	  	SECTION 4 - PERSONAL HEALTH SUPPORT

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 5 - PLAN HIGHLIGHTS 
 The table below provides an overview of Copays that apply when you receive certain Covered Health Services, and outlines the Plan’s Annual Deductible, Out-of-Pocket Maximum and Lifetime Maximum
Benefit. 
  

					
	  

Plan Features
  
	  	  

Network
  
	  	  

Non-Network
  

	  
 Copays1

 
	  		  	 
	  
 •  Emergency Health Services (copay waived if admitted)
	  	$100	  	$100
	  

•  Urgent Care Center Services

 
	  	 $20

 
	  	 $40

 

	  
 Annual
Deductible2
	  	 	  	 
	  

•  Individual
  
	  	 $300

 
	  	 $500

 

	  

•  Family
  
	  	 $600

 
	  	 $1,000

 

	  
 Annual
Out-of-Pocket Maximum2
	  		  	 
	  

•  Individual
  
	  	 $800

 
	  	 $2,500

 

	  

•  Family (not to exceed $800 per Covered Person for Network Benefits or not to exceed $2,500 per
Covered Person for Non-Network Benefits)
  
	  	 $1,600

 
	  	 $5,000

 

	  
 Lifetime Maximum Benefit
  
	  	
$1,000,000 per Covered Person, per lifetime

 

  

	1	 In addition to these Copays, you may be responsible for meeting the Annual Deductible for the Covered Health Services described in the chart on the
following pages. With the exception of Emergency Health Services and Urgent Care Center Services, a Copay does not apply when you visit a non-Network provider. 

	2	 Copays do not apply toward the Annual Deductible and Out-of-Pocket Maximum. The Annual Deductible applies toward the Out-of-Pocket Maximum for all
Covered Health Services. 

  
  

			
	 16
	  	SECTION 5 - PLAN HIGHLIGHTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 This table provides an overview of the Plan’s coverage levels. For detailed descriptions of your
Benefits, refer to Section 6, Additional Coverage Details. 
  

					
	Covered Health Services1	  	  

Percentage of Eligible Expenses
 Payable by the Plan:
  

	  	  
 Network
  
	  	  
 Non-Network
  

	Ambulance Services	  	 	  	 
	  

•   Emergency Ambulance
	  	  

80% after you meet
 the Annual
 Deductible

 
	  	  
 80% after you meet
 the Annual

Deductible
  

	  

•   Non-Emergency Ambulance
	  	  
 80% after you meet
 the Annual

Deductible
  
	  	  
 80% after you meet
 the Annual

Deductible
  

	  
 Cancer Resource Services (CRS)2
	  	 	  	 
	  

•   Hospital Inpatient Stay
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Chiropractic Treatment
  

Up to 20 visits per calendar year
	  	  
 90% and after you
 meet the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Congenital Heart Disease (CHD) Surgeries
	  	  
 90% and after you
 meet the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Dental Services - Accident Only
  

Up to $3,000 per calendar year. Benefits are further limited to a maximum of $900 per tooth.

 
	  	  
 90% after you meet
 the Annual

Deductible
	  	  
 90% after you meet
 the Annual

Deductible

	  
 Diabetes Services
  
	  	 
	  
 Diabetes Self-Management and Training/ Diabetic Eye Examinations/Foot Care
	  	 Depending upon where the Covered
Health
 Service is provided, Benefits for diabetes
 self-management and training/diabetic eye
 examinations/foot care will be paid
the
 same as those stated under each Covered
 Health Service category in this section.

	  

Diabetes Self-Management Items
  

•   diabetes equipment

 
 •   diabetes
supplies
	  	 Benefits for diabetes equipment
will be the
 same as those stated under Durable Medical

Equipment in this section.

  
  

			
	 17
	  	SECTION 5 - PLAN HIGHLIGHTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

					
	Covered Health Services1	  	  

Percentage of Eligible Expenses
 Payable by the Plan:
  

	  	  
 Network
  
	  	  
 Non-Network
  

	  

Durable Medical Equipment (DME)
  

See Section 6, Additional Coverage Details, for limits.
  
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Emergency Health Services - Outpatient
  

Copay is waived if admitted.
  
	  	 90% after you pay a

$100 Copay and after

you meet the Annual

Deductible
	  	  
 90% after you pay a
 $100 Copay and

after you meet the

Annual Deductible
  

	  

Home Health Care
  

Up to 60 visits per calendar year

 
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Hospice Care
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Hospital - Inpatient Stay
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Kidney Resource Services (KRS)
  

(These Benefits are for Covered Health
 Services
provided through KRS only)
  
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Lab, X-Ray and Diagnostics - Outpatient
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Lab, X-Ray and Major Diagnostics –

CT, PET, MRI, MRA and Nuclear
 Medicine
- Outpatient
  
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Mental Health and Substance Abuse

Services - Inpatient and Intermediate
  

Up to 30 days per calendar year for Mental Health and up to 30 days per calendar year for Substance Abuse.

 
	  	 90% after you meet

the Annual

Deductible
	  	 60% after
you meet
 the Annual
 Deductible

	  

Mental Health and Substance Abuse

Services - Outpatient
  
 Up to 30 visits per Calendar year for Mental Health and up to 20 visits per calendar year for Substance Abuse
  
	  	 90% after you meet

the Annual

Deductible
	  	 60% after
you meet
 the Annual
 Deductible

  
  

			
	 18
	  	SECTION 5 - PLAN HIGHLIGHTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

					
	Covered Health Services1	  	  

Percentage of Eligible Expenses
 Payable by the Plan:
  

	  	  
 Network
  
	  	  
 Non-Network
  

	  

Nutritional Counseling
  

Up to three visits per condition per lifetime

 
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	Not Covered
	 Obesity Surgery

 
 Limited to $50,000 per Lifetime
	  	 	  	 
	  

•   Physician’s Office Services
	  	  
 90% after
you meet
 the Annual
 Deductible
  
	  	 Not Covered

	  

•   Physician Fees for Surgical and Medical Services
	  	  
 90% after
you meet
 the Annual
 Deductible
  
	  	 Not Covered

 

	  

•   Hospital - Inpatient Stay
	  	  
 90% after
you meet
 the Annual
 Deductible
  
	  	 Not Covered

 

	 See Section 6, Additional Coverage Details for limits
  
	  	 	  	 
	  

Ostomy Supplies
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Pharmaceutical Products - Outpatient
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  
 Physician Fees for Surgical and
 Medical Services
	  	 	  	 
	 	  	 90% after you meet

the Annual

Deductible
	  	 60% after you meet

the Annual

Deductible

	  

•   UnitedHealth Premium Program

 
 These Benefits are for Covered Health Services provided by a Network Physician
designated in the UnitedHealth Premium Program for:
  
 •   all specialties except family medicine, internal medicine, obstetrics/gynecology, and pediatrics for which we provide designation.
	  	 90% after you meet

the Annual

Deductible
  
	  	 Not Applicable to

Non-Network
  

  
  

			
	 19
	  	SECTION 5 - PLAN HIGHLIGHTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

					
	Covered Health Services1	  	  

Percentage of Eligible Expenses
 Payable by the Plan:
  

	  	  
 Network
  
	  	  
 Non-Network
  

	  
 You can determine the specific services for which benefits are available by going to myuhc.com or by calling the telephone number on your ID card.
	  	 	  	 
	  
 Physician’s Office Services - Sickness and Injury
	  	  
 90% after
you meet
 the Annual
 Deductible
	  	 60% after you meet

the Annual

Deductible

	
•   UnitedHealth Premium Program

 
 These Benefits are for Covered Health Services provided by a Network Physician
designated in the UnitedHealth Premium Program for:
  
 •   all specialties except family medicine, internal medicine, obstetrics/gynecology, and pediatrics for which we provide designation.

 
	  	 90% after you meet

the Annual

Deductible
  
	  	 Not Applicable to

Non-Network

	  

You can determine the specific services for which benefits are available by going to myuhc.com or by calling the telephone number on your ID
card.
  
	  	 	  	 
	Pregnancy – Maternity Services Benefits for Dependent Children are not
covered.	  	 	  	 
	  

•   Physician’s Office Services
	  	  
 90% after
you meet
 the Annual
 Deductible
  
	  	 60% after you meet

the Annual

Deductible
  

	  

•   Hospital - Inpatient Stay
	  	  
 90% after
you meet
 the Annual
 Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

•   Physician Fees for Surgical and Medical Services
	  	  
 90% after
you meet
 the Annual
 Deductible
	  	  
 60% after you meet
 the Annual

Deductible

  
  

			
	 20
	  	SECTION 5 - PLAN HIGHLIGHTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

					
	Covered Health Services1	  	  

Percentage of Eligible Expenses
 Payable by the Plan:
  

	  	  
 Network
  
	  	  
 Non-Network
  

	 A Deductible
will not apply for a newborn child whose length of stay in the Hospital is the same as the mother’s length of stay.
  
	  	 	  	 
	  
 Preventive Care Services
  
	  	 	  	 
	  

•   Physician Office Services, Lab, X-ray or Other Preventive Tests
	  	  
 100% up to $500,
 then 90% after you

meet the Annual

Deductible
  
	  	Not Covered
	  

Prosthetic Devices
  
 Up to $5,000 per calendar year this is a combined limited with Durable Medical Equipment.
  
	  	 90% after you meet

the Annual

Deductible
	  	 60% after
you meet
 the Annual
 Deductible

	  
 Reconstructive Procedures
  
	  	 	  	 
	 •   Physician’s
Office Services
	  	 90% after you meet

the Annual

Deductible
  
	  	 60% after you meet

the Annual

Deductible
  

	  

•   Hospital - Inpatient Stay
	  	  
 90% after
you meet
 the Annual
 Deductible
	  	  
 60% and after you meet
 the Annual

Deductible

	  

•   Physician Fees for Surgical and Medical Services
	  	  
 90% after
you meet
 the Annual
 Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

•   Prosthetic Devices
	  	  
 90% after
you meet
 the Annual
 Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	 •   Surgery - Outpatient
  

See Section 6, Additional Coverage Details

 
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  
 Rehabilitation Services - Outpatient Therapy and Chiropractic Treatment
  

See Section 6, Additional Coverage Details, for visit limit
	  	  
 90% after
you meet
 the Annual
 Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

  
  

			
	 21
	  	SECTION 5 - PLAN HIGHLIGHTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

					
	Covered Health Services1	  	  

Percentage of Eligible Expenses
 Payable by the Plan:
  

	  	  
 Network
  
	  	  
 Non-Network
  

	  

Scopic Procedures - Outpatient Diagnostic and Therapeutic
	  	  
 90% and after you
 meet the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Skilled Nursing Facility/Inpatient Rehabilitation Facility Services
  

Up to 60 days per calendar year
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	  

Surgery - Outpatient
	  	  
 90% and after you
 meet the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	Therapeutic Treatments - Outpatient	  	  
 90% and after you
 meet the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

	Transplantation Services	  	 90% and after you

meet the Annual

Deductible
  
	  	  
 60% after you meet
 the Annual

Deductible
  

Benefits are limited

to $30,000 per

transplant
  

	  

Travel and Lodging
  
 (If services rendered by a Designated Facility; $10,000 maximum per Lifetime)
  
	  	 For patient and
companion(s) of patient
 undergoing cancer, Congenital Heart

Disease treatment or transplant procedures

 

	  

Urgent Care Center Services
  

(Copay is per visit)
  
	  	  
 90% after you pay a
 $20 Copay and after

you meet the Annual

Deductible
  
	  	 60% after
you meet
 the Annual
 Deductible

	 Vision
Examinations
  
 Up to 1 exam per
every 2 calendar years.
  
	  	 90% after you meet

the Annual

Deductible
  
	  	Not Covered
	
Wigs
  

1 per Lifetime
  
	  	  
 90% after you meet
 the Annual

Deductible
  
	  	 60% after
you meet
 the Annual
 Deductible

  
  

			
	 22
	  	SECTION 5 - PLAN HIGHLIGHTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

					
	Covered Health Services1	 	  

Percentage of Eligible Expenses
 Payable by the Plan
  

	 	  

Network
  
	 	  
 Non-Network

  

	1	 You must notify Personal Health Support, as described in Section 4, Personal Health Support to receive full Benefits before receiving
certain Covered Health Services from a non-Network provider. In general, if you visit a Network provider, that provider is responsible for notifying Personal Health Support before you receive certain Covered Health Services. See Section 6,
Additional Coverage Details for further information. 

	2	 These Benefits are for Covered Health Services provided through CRS at a Designated Facility. For oncology services not provided through CRS, the Plan
pays Benefits as described under Physician’s Office Services - Sickness and Injury, Physician Fees for Surgical and Medical Services, Hospital - Inpatient Stay, Surgery - Outpatient, Scopic Procedures - Outpatient
Diagnostic and Therapeutic Lab, X-Ray and Diagnostics – Outpatient, and Lab, X-Ray and Major Diagnostics – CT, PET, MRI, MRA and Nuclear Medicine – Outpatient. 

  
  

			
	 23
	  	SECTION 5 - PLAN HIGHLIGHTS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 6 - ADDITIONAL COVERAGE DETAILS 
 What this section includes: 
  

	•	 	 Covered Health Services for which the Plan pays Benefits; and 

 

	•	 	 Covered Health Services that require you to notify Personal Health Support before you receive them, and any reduction in Benefits that may apply if you
do not call Personal Health Support. 

 This section supplements the second table in Section 5, Plan Highlights.

 While the table provides you with benefit limitations along with Copayment, Coinsurance and Annual Deductible information for each Covered
Health Service, this section includes descriptions of the Benefits. These descriptions include any additional limitations that may apply, as well as Covered Health Services for which you must call Personal Health Support. The Covered Health Services
in this section appear in the same order as they do in the table for easy reference. Services that are not covered are described in Section 8, Exclusions. 
 Ambulance Services 
 The Plan covers Emergency ambulance services and transportation
provided by a licensed ambulance service to the nearest Hospital that offers Emergency Health Services. See Section 14, Glossary for the definition of Emergency. 
 Ambulance service by air is covered in an Emergency if ground transportation is impossible, or would put your life or health in serious jeopardy. If special circumstances exist, UnitedHealthcare may pay
Benefits for Emergency air transportation to a Hospital that is not the closest facility to provide Emergency Health Services. 
 When
transportation is initiated by Unitedhealthcare from a non network Hospital to a network Hospital when the member was admitted in an emergency life threatening situation and is later stablized, the ambulance fee will be waived. 

The Plan also covers transportation provided by a licensed professional ambulance, (either ground or air ambulance, as UnitedHealthcare determines
appropriate) between facilities when the transport is: 
  

	•	 	 from a non-Network Hospital to a Network Hospital; 

  

	•	 	 to a Hospital that provides a higher level of care that was not available at the original Hospital; 

 

	•	 	 to a more cost-effective acute care facility; or 

  

	•	 	 from an acute facility to a sub-acute setting. 

 Please remember that you should notify Personal Health Support for non-Emergency ambulance services as soon as possible prior to transport. If Personal Health Support is not notified, Benefits will be
reduced to 50% of Eligible Expenses. 

  
  

			
	 24
	  	SECTION 6 - ADDITIONAL COVERAGE DETAILS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Cancer Resource Services (CRS) 
 The Plan pays Benefits for oncology services provided by Designated Facilities participating in the Cancer Resource Services (CRS) program. Designated Facility is defined in Section 14,
Glossary. 
 For oncology services and supplies to be considered Covered Health Services, they must be provided to treat a condition that
has a primary or suspected diagnosis relating to cancer. If you or a covered Dependent has cancer, you may: 
  

	•	 	 be referred to CRS by a Personal Health Support Nurse; 

 

	•	 	 call CRS toll-free at (866) 936-6002; or 

  

	•	 	 visit www.urncrs.com. 

 To
receive Benefits for a cancer-related treatment, you are not required to visit a Designated Facility. If you receive oncology services from a facility that is not a Designated Facility, the Plan pays Benefits as described under: 

 

	•	 	 Physician’s Office Services - Sickness and Injury; 

 

	•	 	 Physician Fees for Surgical and Medical Services; 

  

	•	 	 Scopic Procedures - Outpatient Diagnostic and Therapeutic; 

 

	•	 	 Therapeutic Treatments - Outpatient; 

  

	•	 	 Hospital - Inpatient Stay; and 

  

	•	 	 Surgery - Outpatient. 

Note: The services described under Travel and Lodging are Covered Health Services only in connection with cancer-related services
received at a Designated Facility. 
 To receive Benefits under the CRS program, you must contact CRS prior to obtaining Covered Health
Services. The Plan will only pay Benefits under the CRS program if CRS provides the proper notification to the Designated Facility provider performing the services (even if you self refer to a provider in that Network). 

Chiropractic Treatment 
  

	•	 	 Up to 20 visits per calendar year for Chiropractic Treatment. 

 Congenital Heart Disease (CHD) Surgeries 
 The Plan pays Benefits for Congenital Heart
Disease (CHD) services ordered by a Physician and received at a CHD Resource Services program. Benefits are available for the following CHD services: 
  

	•	 	 outpatient diagnostic testing; 

  

	•	 	 evaluation; 

  

	•	 	 surgical interventions; 

  
  

			
	 25
	  	SECTION 6 - ADDITIONAL COVERAGE DETAILS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 interventional cardiac catheterizations (insertion of a tubular device in the heart); 

 

	•	 	 fetal echocardiograms (examination, measurement and diagnosis of the heart using ultrasound technology); and 

 

	•	 	 approved fetal interventions. 

 CHD services other than those listed above are excluded from coverage, unless determined by United Resource Networks or Personal Health Support to be proven procedures for the involved diagnoses. Contact
United Resource Networks at (888) 936-7246 or Personal Health Support at the toll-free number on your ID card for information about CHD services. 
 If you receive Congenital Heart Disease services from a facility that is not a Designated Facility, the Plan pays Benefits as described under: 

 

	•	 	 Physician’s Office Services - Sickness and Injury; 

 

	•	 	 Physician Fees for Surgical and Medical Services; 

  

	•	 	 Scopic Procedures - Outpatient Diagnostic and Therapeutic; 

 

	•	 	 Therapeutic Treatments - Outpatient; 

  

	•	 	 Hospital - Inpatient Stay; and 

  

	•	 	 Surgery - Outpatient. 

Please remember for Non-Network Benefits, you must notify United Resource Networks or Personal Health Support as soon as CHD is suspected or diagnosed.
If United Resource Networks or Personal Health Support is not notified, Benefits for Covered Health Services will be reduced to 50% of Eligible Expenses. 
 Note: The services described under Travel and Lodging are Covered Health Services only in connection with CHD services received at a Congenital Heart Disease Resource Services
program. 
 Dental Services - Accident Only 
 Dental services are covered by the Plan when all of the following are true: 
  

	•	 	 treatment is necessary because of accidental damage; 

  

	•	 	 dental damage does not occur as a result of normal activities of daily living or extraordinary use of the teeth; 

 

	•	 	 dental services are received from a Doctor of Dental Surgery or a Doctor of Medical Dentistry; and 

 

	•	 	 the dental damage is severe enough that initial contact with a Physician or dentist occurs within 72 hours of the accident. (You may request an
extension of this time period provided that you do so within 60 days of the Injury and if extenuating circumstances exist due to the severity of the Injury.) 

  
  

			
	 26
	  	SECTION 6 - ADDITIONAL COVERAGE DETAILS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 The following services are also covered by the Plan: 

 

	•	 	 dental services related to medical transplant procedures; 

 

	•	 	 initiation of immunosuppressives (medication used to reduce inflammation and suppress the immune system); and 

 

	•	 	 direct treatment of cancer or cleft palate. 

 Dental services for final treatment to repair the damage caused by accidental Injury must be started within three months of the accident unless extenuating circumstances exist (such as prolonged
hospitalization or the presence of fixation wires from fracture care) and completed within 12 months of the accident. 
 The Plan pays for
treatment of accidental Injury only for: 
  

	•	 	 emergency examination; 

  

	•	 	 necessary diagnostic x-rays; 

  

	•	 	 endodontic (root canal) treatment; 

  

	•	 	 temporary splinting of teeth; 

  

	•	 	 prefabricated post and core; 

  

	•	 	 simple minimal restorative procedures (fillings); 

  

	•	 	 extractions; 

  

	•	 	 post-traumatic crowns if such are the only clinically acceptable treatment; and 

 

	•	 	 replacement of lost teeth due to the Injury by implant, dentures or bridges. 

Please remember that you should notify Personal Health Support as soon as possible, but at least five business days before follow-up (post-Emergency)
treatment begins. You do not have to provide notification before the initial Emergency treatment. When you provide notification, Personal Health Support can determine whether the service is a Covered Health Service. 

Diabetes Services 
 The Plan pays
Benefits for the Covered Health Services identified below. 
  

			
	Covered Diabetes Services
	  
 Diabetes Self-Management and Training/Diabetic Eye Examinations/Foot Care
	  	  
 Benefits
include outpatient self-management training for the treatment of diabetes, education and medical nutrition therapy services. These services must be ordered by a Physician and provided by appropriately licensed or registered healthcare
professionals.
  
 Benefits under this section also include medical eye
examinations (dilated retinal examinations) and preventive foot care for Covered Persons with diabetes.

  
  

			
	 27
	  	SECTION 6 - ADDITIONAL COVERAGE DETAILS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

			
	Covered Diabetes Services
	  
 Diabetic Self-Management Items
	  	  
 Insulin
pumps and supplies for the management and treatment of diabetes, based upon the medical needs of the Covered Person including, but not limited to:
  

•   blood glucose monitors;

 
 •   insulin syringes
with needles;
  

•   blood glucose and urine test strips;

 
 •   ketone test strips
and tablets; and
  

•   lancets and lancet devices.

 
 Insulin pumps are subject to all the conditions of coverage stated under Durable
Medical Equipment in this section.
  
 Benefits for diabetes equipment
that meet the definition of Durable Medical Equipment are subject to the limit stated under Durable Medical Equipment in this section.

 Please remember for Non-Network Benefits, you must notify Personal Health Support before obtaining any Durable Medical Equipment for the management and treatment of diabetes if the purchase, rental,
repair or replacement of DME will cost more than $1,000. You must purchase or rent the DME from the vendor Personal Health Support identifies. If Personal Health Support is not notified, Benefits will be reduced to 50% of Eligible Expenses.

 Durable Medical Equipment (DME) 
 The Plan pays for Durable Medical Equipment (DME) that is: 
  

	•	 	 ordered or provided by a Physician for outpatient use; 

 

	•	 	 used for medical purposes; 

  

	•	 	 not consumable or disposable; 

  

	•	 	 not of use to a person in the absence of a Sickness, Injury or disability; 

 

	•	 	 durable enough to withstand repeated use; and 

  

	•	 	 appropriate for use in the home. 

 If more than one piece of DME can meet your functional needs, you will receive Benefits only for the most Cost-Effective piece of equipment. Benefits are provided for a single unit of DME (example: one
insulin pump) and for repairs of that unit. If you rent or purchase a piece of Durable Medical Equipment that exceeds this guideline, you may be responsible for any cost difference between the piece you rent or purchase and the piece
UnitedHealthcare has determined is the most Cost-Effective. 

  
  

			
	 28
	  	SECTION 6 - ADDITIONAL COVERAGE DETAILS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Examples of DME include but are not limited to: 

 

	•	 	 equipment to administer oxygen; 

  

	•	 	 wheelchairs; 

  

	•	 	 Hospital beds; 

  

	•	 	 delivery pumps for tube feedings; 

  

	•	 	 burn garments; 

  

	•	 	 insulin pumps and all related necessary supplies as described under Diabetes Services in this section; 

 

	•	 	 braces that straighten or change the shape of a body part; 

 

	•	 	 braces that stabilize an injured body part, including necessary adjustments to shoes to accommodate braces; and 

 

	•	 	 equipment for the treatment of chronic or acute respiratory failure or conditions. 

The Plan also covers tubings, nasal cannulas, connectors and masks used in connection with DME. 
 Note: DME is different from prosthetic devices – see Prosthetic Devices in this section. 
 Any combination of Network Benefits and Non-Network Benefits for the purchase, repair and replacement of DME and Prosthetic Devices is limited to $5,000 per calendar year. 

Benefits are provided for the repair/replacement of a type of Durable Medical Equipment once every three calendar years. 

Please remember for Non-Network Benefits, you must notify Personal Health Support if the purchase, rental, repair or replacement of DME will cost more
than $1,000. You must purchase or rent the DME from the vendor Personal Health Support identifies. If Personal Health Support is not notified, Benefits will be reduced to 50% of Eligible Expenses. 

Emergency Health Services - Outpatient 

The Plan’s Emergency services Benefit pays for outpatient treatment at a Hospital or Alternate Facility when required to stabilize a patient or
initiate treatment. 
 If you are admitted as an inpatient to a Network Hospital directly from the Emergency room, you will not have to pay the
Copay for Emergency Health Services. The Benefits for an Inpatient Stay in a Network Hospital will apply instead. 
 Network Benefits will be
paid for an Emergency admission to a non-Network Hospital as long as Personal Health Support is notified within one business day of the admission or on 

  
  

			
	 29
	  	SECTION 6 - ADDITIONAL COVERAGE DETAILS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 
the same day of admission if reasonably possible after you are admitted to a non-Network Hospital. If you continue your stay in a non-Network Hospital after the date your Physician determines
that it is medically appropriate to transfer you to a Network Hospital, Non-Network Benefits will apply. 
 Benefits under this section are not
available for services to treat a condition that does not meet the definition of an Emergency. 
 Please remember for Non-Network Benefits, you
must notify Personal Health Support within one business day of the admission or on the same day of admission if reasonably possible if you are admitted to a Hospital as a result of an Emergency. If Personal Health Support is not notified, Benefits
for the Inpatient Hospital Stay will be reduced to 50% of Eligible Expenses. 
 Home Health Care 

Covered Health Services are services that a Home Health Agency provides if you need care in your home due to the nature of your condition. Services must
be: 
  

	•	 	 ordered by a Physician; 

  

	•	 	 provided by or supervised by a registered nurse in your home, or provided by either a home health aide or licensed practical nurse and supervised by a
registered nurse; 

  

	•	 	 not considered Custodial Care, as defined in Section 14, Glossary; and 

 

	•	 	 provided on a part-time, intermittent schedule when Skilled Care is required. Refer to Section 14, Glossary for the definition of Skilled
Care. 

 Personal Health Support will decide if Skilled Care is needed by reviewing both the skilled nature of the service and
the need for Physician-directed medical management. A service will not be determined to be “skilled” simply because there is not an available caregiver. 
 Any combination of Network Benefits and Non-Network Benefits is limited to 60 visits per calendar year. One visit equals four hours of Skilled Care services. This visit limit does not include any service
which is billed only for the administration of intravenous infusion. 
 Please remember for Non-Network Benefits, you must notify Personal
Health Support five business days before receiving services or as soon as reasonably possible. If Personal Health Support is not notified, Benefits will be reduced to 50% of Eligible Expenses. 

Hospice Care 
 Hospice care is an
integrated program recommended by a Physician which provides comfort and support services for the terminally ill. Hospice care can be provided on an inpatient or outpatient basis and includes physical, psychological, social and spiritual care for
the terminally ill person, and short-term grief counseling for immediate family members while the Covered Person is receiving hospice care. Benefits are available only when hospice care is received from a licensed hospice agency, which can include a
Hospital. 

  
  

			
	 30
	  	SECTION 6 - ADDITIONAL COVERAGE DETAILS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Please remember for Non-Network Benefits, you must notify Personal Health Support five business days
before receiving services. If Personal Health Support is not notified, Benefits will be reduced to 50% of Eligible Expenses. 
 Hospital -
Inpatient Stay 
 Hospital Benefits are available for: 
  

	•	 	 non-Physician services and supplies received during an Inpatient Stay; 

 

	•	 	 room and board in a Semi-private Room (a room with two or more beds); and 

 

	•	 	 Emergency room Physicians. 

The Plan will pay the difference in cost between a Semi-private Room and a private room only if a private room is necessary according to generally
accepted medical practice. 
 Benefits for an Inpatient Stay in a Hospital are available only when the Inpatient Stay is necessary to prevent,
diagnose or treat a Sickness or Injury. Benefits for other Hospital-based Physician services, including consulting Physicians, anesthesiologists, pathologists and radiologists, are described in this section under Physician Fees for Surgical and
Medical Services. 
 Benefits for Emergency admissions and admissions of less than 24 hours are described under Emergency Health
Services and Surgery - Outpatient, Scopic Procedures - Diagnostic and Therapeutic Services, and Therapeutic Treatments - Outpatient, respectively. 
 Please remember for Non-Network Benefits, you must notify Personal Health Support as follows: 
  

	•	 	 for elective admissions: five business days before admission or as soon as reasonably possible; 

 

	•	 	 for Emergency admissions (also termed non-elective admissions): within two business days, or as soon as is reasonably possible.

 If Personal Health Support is not notified, Benefits will be reduced to 50% of Eligible Expenses. 

What is Coinsurance? 
 Coinsurance is the
amount you pay for a Covered Health Service, not including the Copay and/or the Deductible. 
 For example, if the Plan pays 90% of Eligible
Expenses for care received from a Network provider, your Coinsurance is 10%. 
 Kidney Resource Services (KRS) 

The Plan pays Benefits for Comprehensive Kidney Solution (CKS) that covers both chronic kidney disease and End Stage Renal Disease (ESRD) disease provided
by Designated Facilities participating in the Kidney Resource Services (KRS) program. Designated Facility is defined in Section 14, Glossary. 

  
  

			
	 31
	  	SECTION 6 - ADDITIONAL COVERAGE DETAILS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 In order to receive Benefits under this program, KRS must provide the proper notification to the Network
provider performing the services. This is true even if you self refer to a Network provider participating in the program. Notification is required: 
  

	•	 	 prior to vascular access placement for dialysis; and 

  

	•	 	 prior to any ESRD services. 

You or a covered Dependent may: 
  

	•	 	 be referred to KRS by Personal Health Support; or 

  

	•	 	 call KRS toll-free at (888) 936-7246 and select the KRS prompt. 

 To receive Benefits related to ESRD and chronic kidney disease, you are not required to visit a Designated Facility. If you receive services from a facility that is not a Designated Facility, the Plan
pays Benefits as described under: 
  

	•	 	 Physician’s Office Services - Sickness and Injury; 

 

	•	 	 Physician Fees for Surgical and Medical Services; 

  

	•	 	 Scopic Procedures - Outpatient Diagnostic and Therapeutic; 

 

	•	 	 Therapeutic Treatments - Outpatient; 

  

	•	 	 Hospital - Inpatient Stay; and 

  

	•	 	 Surgery - Outpatient. 

 To
receive Benefits under the KRS program, you must contact KRS prior to obtaining Covered Health Services. The Plan will only pay Benefits under the KRS program if KRS provides the proper notification to the Designated Facility provider performing the
services (even if you self refer to a provider in that Network). 
 Lab, X-Ray and Diagnostics - Outpatient 

Services for Sickness and Injury-related diagnostic purposes, received on an outpatient basis at a Hospital or Alternate Facility or in a Physician’s
office include, but are not limited to: 
  

	•	 	 lab and radiology/x-ray; and 

  

	•	 	 mammography. 

 Benefits
under this section include the facility charge and the charge for supplies and equipment. 
 When these services are performed in a
Physician’s office, Benefits are described under Physician’s Office Services - Sickness and Injury in this section. 
 Benefits
for other Physician services, including anesthesiologists, pathologists and radiologists, are described in this section under Physician Fees for Surgical and Medical Services. 

  
  

			
	 32
	  	SECTION 6 - ADDITIONAL COVERAGE DETAILS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Lab, X-ray and diagnostic services for preventive care are described under Preventive Care
Services in this section. 
 Lab, X-Ray and Major Diagnostics - CT, PET Scans, MRI, MRA and Nuclear Medicine - Outpatient 

Services for CT scans, PET scans, MRI, MRA, nuclear medicine, and major diagnostic services received on an outpatient basis at a Hospital or Alternate
Facility or in a Physician’s office. 
 Benefits under this section include the facility charge and the charge for supplies and equipment.

 When these services are performed in a Physician’s office, Benefits are described under Physician’s Office Services - Sickness
and Injury in this section. Benefits for other Physician services, including anesthesiologists, pathologists and radiologists, are described in this section under Physician Fees for Surgical and Medical Services. 

Mental Health and Substance Abuse Services - Inpatient and Intermediate 
 The Plan covers Mental Health and Substance Abuse (MH/SA) Services, which are: 
  

	•	 	 pre-authorized by the MH/SA Administrator, who is responsible for coordinating all of your care; and 

 

	•	 	 received on an inpatient or intermediate care basis in a Hospital or an Alternate Facility which provides Mental Health or Substance Abuse Services.

 The Plan will only pay for treatment of the diagnoses which are identified in the current edition of the American
Psychiatric Association’s (APA’s) Diagnostic and Statistical Manual of Mental Disorders. Benefits include detoxification from abusive chemicals or substances when necessary to protect your health. APA’s website is www.apa.org.

 If the MH/SA Administrator determines that an Inpatient Stay is required, it is covered on a semi-private room (a room with two or more beds)
basis. At the sole discretion of the MH/SA Administrator, two sessions of intermediate care (such as partial hospitalization) may be provided in lieu of one inpatient day. 
 Inpatient MH/SA Services are subject to the following calendar year limits, which apply to Network and Non-Network Benefits combined. 

 

					
	  

Calendar year Limit On
  
	 	 Inpatient
Mental Health
  
	 	
Inpatient Substance Abuse
  

	  

Inpatient days
  
	 	  
 30
	 	  
 30

  

	*	One day of inpatient treatment is equivalent to: 

  

	 	•	 	 two sessions of partial hospitalization/day treatment; 

 

	 	•	 	 five sessions of intensive outpatient treatment; 

  

	 	•	 	 six outpatient visits; or 

  

	 	•	 	 ten days of Transitional Care (either sober living or transitional living arrangements). 

  
  

			
	 33
	  	SECTION 6 - ADDITIONAL COVERAGE DETAILS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Please remember that you must call the MH/SA Administrator and get authorization to receive these
Benefits in advance of any treatment. Please call the mental health services phone number that appears on your ID card. Without authorization, you will be responsible for paying all charges and no Benefits will be paid. 

Mental Health and Substance Abuse Services - Outpatient 
 The Plan covers MH/SA Services received on an outpatient basis in a provider’s office or at an Alternate Facility, including the following: 

 

	•	 	 mental health/substance abuse evaluations and assessment; 

 

	•	 	 diagnosis; 

  

	•	 	 treatment planning; 

  

	•	 	 referral services; 

  

	•	 	 medication management; 

  

	•	 	 short-term individual, family and group therapeutic services (including intensive outpatient therapy); 

 

	•	 	 crisis intervention; and 

  

	•	 	 psychological testing. 

For Network Benefits, referrals to a Mental Health/Substance Abuse provider are at the sole discretion of the Mental Health/Substance Abuse
Administrator, who is responsible for coordinating all of your care. Contact the Mental Health/Substance Abuse Administrator regarding Network Benefits for outpatient mental health and substance abuse services prior to receiving services.

 Outpatient MH/SA Services are subject to the following calendar year limits, which apply to Network and Non-Network Benefits combined.

  

					
	  

Calendar year Limit On
  
	 	 Outpatient
Mental Health
  
	 	
Outpatient Substance Abuse
  

	  

visits
  
	 	  
 30
	 	  
 20

 Please remember that you must call the MH/SA Administrator and get
authorization to receive these Benefits. Please call the mental health services phone number that appears on your ID card. Without authorization, you will be responsible for paying all charges and no Benefits will be paid. 

Nutritional Counseling 
 The Plan will
pay for Covered Health Services for medical education services provided in a Physician’s office by an appropriately licensed or healthcare professional when: 
  

	•	 	 education is required for a disease in which patient self-management is an important component of treatment; and 

  
  

			
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	•	 	 there exists a knowledge deficit regarding the disease which requires the intervention of a trained health professional. 

Some examples of such medical conditions include: 
  

	•	 	 coronary artery disease; 

  

	•	 	 congestive heart failure; 

  

	•	 	 severe obstructive airway disease; 

  

	•	 	 gout (a form of arthritis); 

  

	•	 	 renal failure; 

  

	•	 	 phenylketonuria (a genetic disorder diagnosed at infancy); and 

 

	•	 	 hyperlipidemia (excess of fatty substances in the blood). 

 Benefits are limited to three individual sessions in your lifetime for each medical condition. 

Obesity Surgery 
 The Plan covers
surgical treatment of obesity provided by or under the direction of a Physician and received on an inpatient basis provided either of the following are true: 
  

	•	 	 you have a minimum Body Mass Index (BMI) of 40; or 

  

	•	 	 you have a minimum BMI of 35 with complicating co-morbidities (such as sleep apnea or diabetes) directly related to, or exacerbated by obesity.

 Benefits are available for obesity surgery services that meet the definition of a Covered Health Service, as defined in
Section 14, Glossary and are not Experimental or Investigational or Unproven Services. 
 Network Benefits are limited to $50,000
during the entire period you are covered under the Plan. 
 Please remember for Network Benefits, you must notify Personal Health Support as
soon as the possibility of obesity surgery arises. Personal Health Support If Personal Health Support is not notified, Benefits will be reduced to 50% of Eligible Expenses. 
 Ostomy Supplies 
 Benefits for ostomy supplies are limited to: 

 

	•	 	 pouches, face plates and belts; 

  

	•	 	 irrigation sleeves, bags and catheters; and 

  

	•	 	 skin barriers. 

  
  

			
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 Pharmaceutical Products - Outpatient 
 The Plan pays for Pharmaceutical Products that are administered on an outpatient basis in a Hospital, Alternate Facility, Physician’s office, or in a Covered Person’s home. Examples of what
would be included under this category are antibiotic injections in the Physician’s office or inhaled medication in an Urgent Care Center for treatment of an asthma attack. 
 Benefits under this section are provided only for Pharmaceutical Products which, due to their characteristics (as determined by UnitedHealthcare), must typically be administered or directly supervised by
a qualified provider or licensed/certified health professional. Benefits under this section do not include medications that are typically available by prescription order or refill at a pharmacy. 

Physician Fees for Surgical and Medical Services 
 The Plan pays Physician fees for surgical procedures and other medical care received from a Physician in a Hospital, Skilled Nursing Facility, Inpatient Rehabilitation Facility, Alternate Facility, or for
Physician house calls. 
 When these services are performed in a Physician’s office, Benefits are described under Physician’s
Office Services - Sickness and Injury in this section. 
 Physician’s Office Services - Sickness and Injury 

Benefits are paid by the Plan for Covered Health Services received in a Primary Physician’s office for the evaluation and treatment of a Sickness or
Injury. Benefits are provided under this section regardless of whether the Physician’s office is free-standing, located in a clinic or located in a Hospital. 
 Benefits for preventive services are described under Preventive Care in this section. 

When a test is performed or a sample is drawn in the Physician’s office and then sent outside the Physician’s office for analysis or testing,
Benefits for lab, radiology/x-rays and other diagnostic services that are performed outside the Physician’s office are described in Lab, X-ray and Diagnostics - Outpatient. 
 Please Note 
 Your Physician does not have a copy of your SPD, and is not responsible for
knowing or communicating your Benefits. 
 Pregnancy - Maternity Services 
 Benefits for Pregnancy will be paid at the same level as Benefits for any other condition, Sickness or Injury. This includes all maternity-related medical services for prenatal care, postnatal care,
delivery, and any related complications. Pregnancy Maternity Services for dependent children are not covered. 
 The Plan will pay Benefits for
an Inpatient Stay of at least: 
  

	•	 	 48 hours for the mother and newborn child following a vaginal delivery; or 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 96 hours for the mother and newborn child following a cesarean section delivery. 

These are federally mandated requirements under the Newborns’ and Mothers’ Health Protection Act of 1996. If the mother agrees, the attending
Physician may discharge the mother and/or the newborn child earlier than these minimum timeframes. 
 Both before and during a Pregnancy,
Benefits include the services of a genetic counselor when provided or referred by a Physician. These Benefits are available to all Covered Persons in the immediate family. Covered Health Services include related tests and treatment. 

Please remember for Non-Network Benefits, you must notify Personal Health Support as soon as reasonably possible if the Inpatient Stay for the mother
and/or the newborn will be longer than the timeframes indicated above. If Personal Health Support is not notified, Benefits for the extended stay will be reduced to 50% of Eligible Expenses. 
 Healthy moms and babies 
 The Plan provides a special prenatal program to help during
Pregnancy. Participation is voluntary and free of charge. See Section 7, Resources to Help you Stay Healthy, for details. 

Preventive Care Services 
 The Plan pays
for services for preventive medical care provided on an outpatient basis at a Physician’s office, an Alternate Facility or a Hospital. 

In general, the Plan pays preventive care Benefits based on the recommendations of the U.S. Preventive Services Task Force (USPSTF) although other
preventive care services may be covered as well. Your Physician may recommend additional services based on your family or medical history. Examples of preventive medical care are listed below and provide a guide of what is considered a Covered
Health Service. 
 Examples of Covered Health Services for preventive care include: 

 

			
	Covered Preventive Care Services
	 Physician
Office Services
	  	
•   routine physical including vision and hearing screenings;

 
 •   metabolic screening
tests (including phenylketonuria (PKU));
  
 •   immunizations1,2;
  
 •   well baby and well child care; and
  

•   routine gynecological exam including breast and pelvic examination, treatment of minor
infections, and PAP test2.

	  

Lab, X-ray or Other Preventive Tests
	  	  

•   mammogram;

 
 •   colorectal cancer
screening;

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

			
	Covered Preventive Care Services
	 	  	
•   cervical cancer screening;

 
 •   PSA blood test and
digital rectal exam; and
  

•   bone mineral density tests.

 

  

	1	 Covered childhood and adult immunizations include those that are recommended by the Center for Disease Control and Prevention’s Advisory Committee
on Immunization Practices (ACIP) and whose recommendations have been published in the Center for Disease Control and Prevention’s Mortality and Morbidity Weekly Report (MMWR). 

	2	 The human papilloma virus (HPV) vaccine is limited to one complete dosage per lifetime. Women over age 18 but under age 26 who have not yet received
the vaccine may receive the vaccine. 

 For questions about your preventive care Benefits under this Plan call the number on
the back of your ID card. 
 Prosthetic Devices 
 Benefits are paid by the Plan for prosthetic devices and appliances that replace a limb or body part, or help an impaired limb or body part work. Examples include, but are not limited to: 

 

	•	 	 artificial arms, legs, feet and hands; 

  

	•	 	 artificial face, eyes, ears and noses; 

  

	•	 	 speech aid prosthetics and tracheo-esophageal voice prosthetics; and 

 

	•	 	 breast prosthesis following mastectomy as required by the Women’s Health and Cancer Rights Act of 1998, including mastectomy bras and lymphedema
stockings for the arm. 

 Benefits under this section are provided only for external prosthetic devices and do not include any
device that is fully implanted into the body other than breast prostheses. 
 If more than one prosthetic device can meet your functional needs,
Benefits are available only for the most Cost-Effective prosthetic device. The device must be ordered or provided either by a Physician, or under a Physician’s direction. If you purchase a prosthetic device that exceeds these minimum
specifications, the Plan may pay only the amount that would have paid for the prosthetic that meets the minimum specifications, and you may be responsible for paying any difference in cost. 
 Any combination of Network Benefits and Non-Network Benefits for the purchase, repair and replacement of prosthetic devices and DME is limited to $5,000 per calendar year. 

Benefits are provided for the replacement of a type of prosthetic device once every three calendar years. 

  
  

			
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 Once this limit is reached, Benefits continue to be available for items required by the Women’s
Health and Cancer Rights Act of 1998. 
 Note: Prosthetic devices are different from DME - see Durable Medical Equipment
(DME) in this section. 
 Reconstructive Procedures 
 Reconstructive Procedures are services performed when the primary purpose of the procedure is either to treat a medical condition or to improve or restore physiologic function for an organ or body part.
Reconstructive procedures include surgery or other procedures which are associated with an Injury, Sickness or Congenital Anomaly. The primary result of the procedure is not a changed or improved physical appearance. 

Improving or restoring physiologic function means that the organ or body part is made to work better. An example of a Reconstructive Procedure is surgery
on the inside of the nose so that a person’s breathing can be improved or restored. 
 Benefits for Reconstructive Procedures include
breast reconstruction following a mastectomy and reconstruction of the non-affected breast to achieve symmetry. Replacement of an existing breast implant is covered by the Plan if the initial breast implant followed mastectomy. Other services
required by the Women’s Health and Cancer Rights Act of 1998, including breast prostheses and treatment of complications, are provided in the same manner and at the same level as those for any other Covered Health Service. You can contact
UnitedHealthcare at the telephone number on your ID card for more information about Benefits for mastectomy-related services. 
 There may be
times when the primary purpose of a procedure is to make a body part work better. However, in other situations, the purpose of the same procedure is to improve the appearance of a body part. Cosmetic procedures are excluded from coverage. Procedures
that correct an anatomical Congenital Anomaly without improving or restoring physiologic function are considered Cosmetic Procedures. A good example is upper eyelid surgery. At times, this procedure will be done to improve vision, which is
considered a Reconstructive Procedure. In other cases, improvement in appearance is the primary intended purpose, which is considered a Cosmetic Procedure. This Plan does not provide Benefits for Cosmetic Procedures, as defined in Section 14,
Glossary. 
 The fact that a Covered Person may suffer psychological consequences or socially avoidant behavior as a result of an Injury,
Sickness or Congenital Anomaly does not classify surgery (or other procedures done to relieve such consequences or behavior) as a reconstructive procedure. 
 Please remember that you must notify Personal Health Support five business days before undergoing a Reconstructive Procedure. When you provide notification, Personal Health Support can determine whether
the service is considered reconstructive or cosmetic. Cosmetic Procedures are always excluded from coverage. 

  
  

			
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 Rehabilitation Services - Outpatient Therapy and Chiropractic Treatment 

The Plan provides short-term outpatient rehabilitation services for the following types of therapy: 

 

	•	 	 physical therapy; 

  

	•	 	 occupational therapy; 

  

	•	 	 speech therapy; 

  

	•	 	 post-cochlear implant aural therapy; 

  

	•	 	 pulmonary rehabilitation; and 

  

	•	 	 cardiac rehabilitation. 

Speech Therapy for Children under Age Three 
 Benefits are paid for services of a licensed speech therapist for treatment given to a child under age three whose speech is impaired due to one of the following conditions: 

 

	•	 	 infantile autism; 

  

	•	 	 development delay or cerebral palsy; 

  

	•	 	 hearing impairment; or 

  

	•	 	 major Congenital Anomalies that affect speech, such as, but not limited to, cleft lip and cleft palate. 

For all rehabilitation services, a licensed therapy provider, under the direction of a Physician, must perform the services. 

The Plan will pay Benefits for speech therapy only when the speech impediment or dysfunction results from Injury, Sickness, stroke, cancer, autism
spectrum disorders or a Congenital Anomaly, or is needed following the placement of a cochlear implant. 
 Benefits are limited to: 

 

	•	 	 20 visits per calendar year for physical therapy; 

  

	•	 	 20 visits per calendar year for occupational therapy; 

 

	•	 	 20 visits per calendar year for speech therapy; 

  

	•	 	 30 visits per calendar year for post-cochlear implant aural therapy; 

 

	•	 	 20 visits per calendar year for pulmonary rehabilitation therapy; and 

 

	•	 	 36 visits per calendar year for cardiac rehabilitation therapy. 

 These visit limits apply to Network Benefits and Non-Network Benefits combined. 

  
  

			
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 Scopic Procedures - Outpatient Diagnostic and Therapeutic 

The Plan pays for diagnostic and therapeutic scopic procedures and related services received on an outpatient basis at a Hospital or Alternate Facility.

 Diagnostic scopic procedures are those for visualization, biopsy and polyp removal. Examples of diagnostic scopic procedures include
colonoscopy, sigmoidoscopy, and endoscopy. 
 Benefits under this section include the facility charge and the charge for supplies and equipment.

 When these services are performed in a Physician’s office, Benefits are described under Physician’s Office Services - Sickness
and Injury in this section. Benefits for other Physician services, including anesthesiologists, pathologists and radiologists, are described in this section under Physician Fees for Surgical and Medical Services. 

Please note that Benefits under this section do not include surgical scopic procedures, which are for the purpose of performing surgery. Benefits for
surgical scopic procedures are described under Surgery - Outpatient. Examples of surgical scopic procedures include arthroscopy, laparoscopy, bronchoscopy, hysteroscopy. 
 Skilled Nursing Facility/Inpatient Rehabilitation Facility Services 
 Facility services for
an Inpatient Stay in a Skilled Nursing Facility or Inpatient Rehabilitation Facility are covered by the Plan. Benefits include: 
  

	•	 	 non-Physician services and supplies received during the Inpatient Stay; and 

 

	•	 	 room and board in a Semi-private Room (a room with two or more beds). 

 Benefits are available when skilled nursing and/or Inpatient Rehabilitation Facility services are needed on a daily basis. Benefits are also available in a Skilled Nursing Facility or Inpatient
Rehabilitation Facility for treatment of a Sickness or Injury that would have otherwise required an Inpatient Stay in a Hospital. 
 Benefits
for other Physician services, including anesthesiologists, consulting Physicians, pathologists and radiologists, are described in this section under Physician Fees for Surgical and Medical Services. 

UnitedHealthcare will determine if Benefits are available by reviewing both the skilled nature of the service and the need for Physician-directed medical
management. A service will not be determined to be “skilled” simply because there is not an available caregiver. 
 Benefits are
available only if: 
  

	•	 	 the initial confinement in a Skilled Nursing Facility or Inpatient Rehabilitation Facility was or will be a cost-effective alternative to an Inpatient
Stay in a Hospital; and 

  

	•	 	 you will receive skilled care services that are not primarily Custodial Care. 

  
  

			
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 Skilled care is skilled nursing, skilled teaching, and skilled rehabilitation services when: 

 

	•	 	 it is delivered or supervised by licensed technical or professional medical personnel in order to obtain the specified medical outcome, and provide for
the safety of the patient; 

  

	•	 	 it is ordered by a Physician; 

  

	•	 	 it is not delivered for the purpose of assisting with activities of daily living, including but not limited to dressing, feeding, bathing or
transferring from a bed to a chair; and 

  

	•	 	 it requires clinical training in order to be delivered safely and effectively. 

You are expected to improve to a predictable level of recovery. Benefits can be denied or shortened for Covered Persons who are not progressing in
goal-directed rehabilitation services or if discharge rehabilitation goals have previously been met. 
 Note: The Plan does not
pay Benefits for Custodial Care or Domiciliary Care, even if ordered by a Physician, as defined in Section 14, Glossary. 
 Any
combination of Network Benefits and Non-Network Benefits is limited to 60 days per calendar year. 
 Please remember for Non-Network Benefits,
you must notify Personal Health Support as follows: 
  

	•	 	 for elective admissions: five business days before admission; 

 

	•	 	 for Emergency admissions (also termed non-elective admissions): within two business days, or as soon as is reasonably possible.

 If Personal Health Support is not notified, Benefits will be reduced to 50% of Eligible Expenses. 

Surgery - Outpatient 
 The Plan pays for
surgery and related services received on an outpatient basis at a Hospital or Alternate Facility. 
 Benefits under this section include:

  

	•	 	 the facility charge and the charge for supplies and equipment; and 

 

	•	 	 certain surgical scopic procedures (examples of surgical scopic procedures include arthroscopy, laparoscopy, bronchoscopy, hysteroscopy).

 Benefits for other Physician services, including anesthesiologists, consulting Physicians, pathologists and radiologists,
are described in this section under Physician Fees for Surgical and Medical Services. When these services are performed in a Physician’s office, Benefits are described under Physician’s Office Services - Sickness and Injury
in this section. 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Therapeutic Treatments - Outpatient 
 The Plan pays Benefits for therapeutic treatments received on an outpatient basis at a Hospital or Alternate Facility, including but not limited to dialysis (both hemodialysis and peritoneal dialysis),
intravenous chemotherapy or other intravenous infusion therapy and radiation oncology. 
 Covered Health Services include medical education
services that are provided on an outpatient basis at a Hospital or Alternate Facility by appropriately licensed or registered healthcare professionals when: 
  

	•	 	 education is required for a disease in which patient self-management is an important component of treatment; and 

 

	•	 	 there exists a knowledge deficit regarding the disease which requires the intervention of a trained health professional. 

Benefits under this section include: 
  

	•	 	 the facility charge and the charge for related supplies and equipment; and 

 

	•	 	 Physician services for anesthesiologists, pathologists and radiologists. Benefits for other Physician services are described in this section under
Physician Fees for Surgical and Medical Services. 

 When these services are performed in a Physician’s office,
Benefits are described under Physician’s Office Services. 
 Please remember for Non-Network Benefits, you must notify Personal
Health Support five business days before scheduled services are received or, for non-scheduled services, within one business day or as soon as reasonably possible. If Personal Health Support is not notified, Benefits will be reduced to 50% of
Eligible Expenses. 
 Transplantation Services 
 Inpatient facility services (including evaluation for transplant, organ procurement and donor searches) for transplantation procedures must be ordered by a provider. Benefits are available to the donor
and the recipient when the recipient is covered under this Plan, for any of the organ and tissue transplants listed below when the transplant meets the definition of a Covered Health Service and is not Experimental or Investigational, or Unproven:

  

	•	 	 heart; 

  

	•	 	 heart/lung; 

  

	•	 	 lung; 

  

	•	 	 kidney; 

  

	•	 	 kidney/pancreas; 

  

	•	 	 liver; 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 liver/kidney; 

  

	•	 	 liver/intestinal; 

  

	•	 	 pancreas; 

  

	•	 	 intestinal; and 

  

	•	 	 bone marrow (either from you or from a compatible donor) and peripheral stem cell transplants, with or without high dose chemotherapy. Not all bone
marrow transplants meet the definition of a Covered Health Service 

 Benefits are also available for cornea transplants. You
are not required to notify United Resource Networks or Personal Health Support of a cornea transplant nor is the cornea transplant required to be performed at a Designated Facility. 
 Donor costs that are directly related to organ removal are Covered Health Services for which Benefits are payable through the organ recipient’s coverage under the Plan. 

The Plan has specific guidelines regarding Benefits for transplant services. Contact United Resource Networks at (888) 936-7246 or Personal Health
Support at the telephone number on your ID card for information about these guidelines. 
 Note: The services described under
Travel and Lodging are Covered Health Services only in connection with transplant services received at a Designated Facility. 
 Please
remember for Non-Network Benefits, you must notify United Resource Networks or Personal Health Support as soon as the possibility of a transplant arises (and before the time a pre-transplantation evaluation is performed at a transplant center). If
United Resource Networks or Personal Health Support is not notified, Benefits will be reduced to 50% of Eligible Expenses. 
 Travel and
Lodging 
 United Resource Networks will assist the patient and family with travel and lodging arrangements related to: 

 

	•	 	 Congenital Heart Disease (CHD); 

  

	•	 	 transplantation services; and 

  

	•	 	 cancer-related treatments. 

For travel and lodging services to be covered, the patient must be receiving services at a Designated Facility. 

The Plan covers expenses for travel, lodging and meals for the patient, provided he or she is not covered by Medicare, and a companion as follows:

  

	•	 	 transportation of the patient and one companion who is traveling on the same day(s) to and/or from the site of the cancer-related treatment, the CHD
service, or the transplant for the purposes of an evaluation, the procedure or necessary post-discharge follow-up; 

  
  

			
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	•	 	 Eligible Expenses for lodging and meals for the patient (while not a Hospital inpatient) and one companion. Benefits are paid at a per diem (per day)
rate of up to $100 per day for the patient plus one companion; or 

  

	•	 	 if the patient is an enrolled Dependent minor child, the transportation expenses of two companions will be covered and lodging and meal expenses will
be reimbursed at a per diem rate up to $100 per day. 

 Travel and lodging expenses are only available if the recipient lives
more than 50 miles from the Designated Facility (for CRS and transplantation) or the CHD facility. UnitedHealthcare must receive valid receipts for such charges before you will be reimbursed. Examples of travel expenses may include: 

 

	•	 	 airfare at coach rate; 

  

	•	 	 taxi or ground transportation; or 

  

	•	 	 mileage reimbursement at the IRS rate for the most direct route between the patient’s home and the Designated Facility.

 A combined overall maximum Benefit of $10,000 per Covered Person applies for all travel, lodging and meal expenses
reimbursed under this Plan in connection with all cancer treatments and transplant procedures and CHD treatments during the entire period that person is covered under this Plan. 
 Support in the event of serious illness 
 If you or a covered family member has cancer or
needs an organ or bone marrow transplant, UnitedHealthcare can put you in touch with quality treatment centers around the country. 
 Urgent
Care Center Services 
 The Plan provides Benefits for services, including professional services, received at an Urgent Care Center, as
defined in Section 14, Glossary. When Urgent Care services are provided in a Physician’s office, the Plan pays Benefits as described under Physician’s Office Services - Sickness and Injury earlier in this section.

 Vision Examinations 
 The
Plan pays Benefits for: 
  

	•	 	 vision screenings, which could be performed as part of an annual physical examination in a provider’s office (vision screenings do not include
refractive examinations to detect vision impairment); and 

  

	•	 	 one routine vision exam, including refraction, to detect vision impairment by a provider in the provider’s office every other calendar year.

  
  

			
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 Wigs 
 The Plan pays Benefits for wigs and other scalp hair prosthesis only for the reason of hair loss resulting from treatment of a malignancy, burns or surgery in which case the Plan pays for 1 wig per
Covered Person per Lifetime. 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 7 - RESOURCES TO HELP YOU STAY HEALTHY 

What this section includes: 
 Health and
well-being resources available to you: 
  

	•	 	 www.myuhc.com; 

  

	•	 	 Optum®
NurseLineSM; 

 

	•	 	 Live Nurse Chat; 

  

	•	 	 Treatment Decision Support; 

  

	•	 	 Healthy Pregnancy Program; and 

  

	•	 	 UnitedHealth
PremiumSM Program on www.myuhc.com.

 Kansas City Life Insurance Company believes in giving you the tools you need to be an educated health care consumer. To
that end, Kansas City Life Insurance Company has made available several convenient educational and support services, accessible by phone and the Internet, which can help you to: 

 

	•	 	 take care of yourself and your family members; 

  

	•	 	 manage a chronic health condition; and 

  

	•	 	 navigate the complexities of the health care system. 

 NOTE: 
 Information obtained through the services identified in this section is based
on current medical literature and on Physician review. It is not intended to replace the advice of a doctor. The information is intended to help you make better health care decisions and take a greater responsibility for your own health.
UnitedHealthcare and Kansas City Life Insurance Company are not responsible for the results of your decisions from the use of the information, including, but not limited to, your choosing to seek or not to seek professional medical care, or your
choosing or not choosing specific treatment based on the text. 
 www.myuhc.com 
 UnitedHealthcare’s member website, www.myuhc.com, provides information at your fingertips anywhere and anytime you have access to the Internet. www.myuhc.com opens the door to a wealth
of health information and convenient self-service tools to meet your needs. 
 Health Information 

With www.myuhc.com you can: 
  

	•	 	 research a health condition and treatment options to get ready for a discussion with your Physician; 

 

	•	 	 search for Network providers available in your Plan through the online provider directory; 

  
  

			
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	•	 	 access all of the content and wellness topics from NurseLine including Live Nurse Chat 24 hours a day, seven days a week; 

 

	•	 	 complete a health risk assessment to identify health habits you can improve, learn about healthy lifestyle techniques and access health improvement
resources; 

  

	•	 	 use the treatment cost estimator to obtain an estimate of the costs of various procedures in your area; and 

 

	•	 	 use the Hospital comparison tool to compare Hospitals in your area on various patient safety and quality measures. 

Self-Service Tools 
 Visit
www.myuhc.com and: 
  

	•	 	 make real-time inquiries into the status and history of your claims; 

 

	•	 	 view eligibility and Plan Benefit information, including Copays and Annual Deductibles; 

 

	•	 	 view and print all of your Explanation of Benefits (EOBs) online; and 

 

	•	 	 order a new or replacement ID card, print a temporary ID card, or check on an ID card request. 

Registering on www.myuhc.com 
 If you
have not already registered as a www.myuhc.com subscriber, simply go to www.myuhc.com and click on “Register Now.” Have your UnitedHealthcare ID card handy. The enrollment process is quick and easy. 

Health Assessment 
 You are
invited to learn more about your health and wellness at www.myuhc.com and are encouraged to participate in the online health assessment. The health assessment is an interactive questionnaire designed to help you identify your healthy habits
as well as potential health risks. 
 Your health assessment is kept confidential. Completing the assessment will not impact your Benefits or
eligibility for Benefits in any way. 
 To find the health assessment, log in to www.myuhc.com. After logging in, access your
personalized Health & Wellness page and click the Health Assessment link. If you need any assistance with the online assessment, please call the number on the back of your ID card. 

Health Improvement Plan 
 You can
start a Health Improvement Plan at any time. This plan is created just for you and includes information and interactive tools, plus online health coaching recommendations based on your profile. 

Online coaching is available for: 
  

	•	 	 nutrition; 

  
  

			
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	•	 	 exercise, 

  

	•	 	 weight management; 

  

	•	 	 stress; 

  

	•	 	 smoking cessation; 

  

	•	 	 diabetes; and 

  

	•	 	 heart health. 

 To help
keep you on track with your Health Improvement Plan and online coaching, you’ll also receive personalized messages and reminders – Kansas City Life Insurance Company’s way of helping you meet your health and wellness goals.

 Optum® NurseLineSM 
 Optum NurseLine is a toll-free telephone service that puts you in immediate contact
with an experienced registered nurse any time, 24 hours a day, seven days a week. Nurses can provide health information for routine or urgent health concerns. When you call, a registered nurse may refer you to any additional resources that Kansas
City Life Insurance Company has available to help you improve your health and well-being or manage a chronic condition. Call any time when you want to learn more about: 
  

	•	 	 a recent diagnosis; 

  

	•	 	 a minor Sickness or Injury; 

  

	•	 	 men’s, women’s, and children’s wellness; 

 

	•	 	 how to take prescription drugs safely; 

  

	•	 	 self-care tips and treatment options; 

  

	•	 	 healthy living habits; or 

  

	•	 	 any other health related topic. 

 NurseLine gives you another convenient way to access health information. By calling the same toll-free number, you can listen to one of the Health Information Library’s over 1,100 recorded messages.
There are also 590 messages available in Spanish. 
 NurseLine is available to you at no cost. To use this convenient service, simply call the
toll-free number on the back of your ID card. 
 Note: If you have a medical emergency, call 911 instead of calling NurseLine.

 Your child is running a fever and it’s 1:00 AM. What do you do? 
 Call NurseLine toll-free at the number on your ID card, any time, 24 hours a day, seven days a week. You can count on NurseLine to help answer your health questions. 

  
  

			
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	  	SECTION 7 - RESOURCES TO HELP YOU STAY
HEALTHY

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Live Nurse Chat 
 With NurseLine, you also have access to nurses online. To use this service, log onto www.myuhc.com and click “Live Nurse Chat” in the top menu bar. You’ll instantly be connected with
a registered nurse who can answer your general health questions any time, 24 hours a day, seven days a week. You can also request an e-mailed transcript of the conversation to use as a reference. 

Note: If you have a medical emergency, call 911 instead of logging onto myuhc.com. 

Live Events on www.myuhc.com 

Periodically, www.myuhc.com hosts live events with leading health care professionals. After viewing a presentation, you can chat online with the
experts. Topics include: 
  

	•	 	 weight control; 

  

	•	 	 parenting; 

  

	•	 	 heart disease; 

  

	•	 	 relationships; and 

  

	•	 	 depression. 

 For details,
or to participate in a live event, log onto www.myuhc.com. 
 Want to learn more about a condition or treatment? 

Log on to www.myuhc.com and research health topics that are of interest to you. Learn about a specific condition, what the symptoms are, how it is
diagnosed, how common it is, and what to ask your Physician. 
 Healthy Pregnancy Program 

If you are pregnant and enrolled in the medical Plan, you can get valuable educational information and advice by calling the toll-free number on your ID
card. This program offers: 
  

	•	 	 maternity nurses on duty 24 hours a day; 

  

	•	 	 a free copy of The Healthy Pregnancy Guide; 

  

	•	 	 a phone call from a maternity nurse halfway through your Pregnancy, to see how things are going; 

 

	•	 	 a phone call from a nurse approximately four weeks postpartum to give you information on infant care, feeding, nutrition, immunizations and more; and

  

	•	 	 a copy of an available publication, for example, Healthy Baby Book, which focuses on the first two years of life. 

Participation is completely voluntary and without extra charge. To take full advantage of the program, you are encouraged to enroll within the first 12
weeks of Pregnancy. You can enroll any time, up to your 34th week. To enroll, call the toll-free number on the back of your ID card. 

  
  

			
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	  	SECTION 7 - RESOURCES TO HELP YOU STAY
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 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 As a program participant, you can call any time, 24 hours a day, seven days a week, with any questions
or concerns you might have. 
 Treatment Decision Support 
 In order to help you make informed decisions about your health care, UnitedHealthcare has a program called Treatment Decision Support. This program targets specific conditions as well as the treatments
and procedures for those conditions. 
 This program offers: 
  

	•	 	 access to accurate, objective and relevant health care information; 

 

	•	 	 coaching by a nurse through decisions in your treatment and care; 

 

	•	 	 expectations of treatment; and 

  

	•	 	 information on high quality providers and programs. 

 Conditions for which this program is available include: 
  

	•	 	 back pain; 

  

	•	 	 knee & hip replacement; 

  

	•	 	 prostate disease; 

  

	•	 	 prostate cancer; 

  

	•	 	 benign uterine conditions; 

  

	•	 	 breast cancer; 

  

	•	 	 coronary disease; and 

  

	•	 	 bariatric surgery. 

Participation is completely voluntary and without extra charge. If you think you may be eligible to participate or would like additional information
regarding the program, please contact the number on the back of your ID card. 
 UnitedHealth PremiumSM Program 

UnitedHealthcare designates Network Physicians and facilities as UnitedHealth Premium Program Physicians or facilities for certain medical conditions.
Physicians and facilities are evaluated on two levels - quality and efficiency of care. The UnitedHealth Premium Program was designed to: 
  

	•	 	 help you make informed decisions on where to receive care; 

 

	•	 	 provide you with decision support resources; and 

  
  

			
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	  	SECTION 7 - RESOURCES TO HELP YOU STAY
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 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 give you access to Physicians and facilities across areas of medicine that have met UnitedHealthcare’s quality and efficiency criteria.

 For details on the UnitedHealth Premium Program including how to locate a UnitedHealth Premium Physician or facility, log
onto www.myuhc.com or call the toll-free number on your ID card. 

  
  

			
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	  	SECTION 7 - RESOURCES TO HELP YOU STAY
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 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 8 - EXCLUSIONS: WHAT THE MEDICAL PLAN WILL NOT COVER 

What this section includes: 
  

	•	 	 Services, supplies and treatments that are not Covered Health Services, except as may be specifically provided for in Section 6, Additional
Coverage Details. 

 The Plan does not pay Benefits for the following services, treatments or supplies even if they are
recommended or prescribed by a provider or are the only available treatment for your condition. 
 When Benefits are limited within any of the
Covered Health Services categories described in Section 6, Additional Coverage Details, those limits are stated in the corresponding Covered Health Service category in Section 5, Plan Highlights. Limits may also apply to some
Covered Health Services that fall under more than one Covered Health Service category. When this occurs, those limits are also stated in Section 5, Plan Highlights. Please review all limits carefully, as the Plan will not pay Benefits
for any of the services, treatments, items or supplies that exceed these benefit limits. 
 Please note that in listing services or examples,
when the SPD says “this includes,” or “including but not limiting to”, it is not UnitedHealthcare’s intent to limit the description to that specific list. When the Plan does intend to limit a list of services or examples,
the SPD specifically states that the list “is limited to.” 
 Alternative Treatments 

 

	1.	acupressure; 

  

	2.	acupuncture; 

  

	3.	aromatherapy; 

  

	4.	hypnotism; 

  

	5.	massage therapy; 

  

	6.	rolfing (holistic tissue massage); and 

  

	7.	art therapy, music therapy, dance therapy, horseback therapy and other forms of alternative treatment as defined by the National Center for Complimentary and
Alternative Medicine (NCCAM) of the National Institutes of Health. This exclusion does not apply to Chiropractic Treatment and osteopathic care for which Benefits are provided as described in Section 6, Additional Coverage Details.

 Dental 
  

	1.	dental care, except as identified under Dental Services - Accident Only in Section 6, Additional Coverage Details; 

  
  

			
	 53
	  	SECTION 8 - EXCLUSIONS

 `KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Dental care that is required to treat the effects of a medical condition, but that is
not necessary to directly treat the medical condition, is excluded. Examples include treatment of dental caries resulting from dry mouth after radiation treatment or as a result of medication. 

Endodontics, periodontal surgery and restorative treatment are excluded. 

 

	2.	diagnosis or treatment of or related to the teeth, jawbones or gums. Examples include: 

 

	 	•	 	 extractions (including wisdom teeth); 

  

	 	•	 	 restoration and replacement of teeth; 

  

	 	•	 	 medical or surgical treatments of dental conditions; and 

 

	 	•	 	 services to improve dental clinical outcomes; 

 This exclusion does not apply to accident-related dental services for which Benefits are provided as described under Dental Services – Accident Only in Section 6, Additional Coverage
Details. 
  

	3.	dental implants , bone grafts, and other implant-related procedures; 

 This exclusion does not apply to accident-related dental services for which Benefits are provided as described under Dental Services – Accident Only in Section 6, Additional Coverage
Details. 
  

	4.	dental braces (orthodontics); 

  

	5.	dental X-rays, supplies and appliances and all associated expenses, including hospitalizations and anesthesia; and 

This exclusion does not apply to dental care (oral examination, X-rays, extractions and non-surgical elimination of oral infection)
required for the direct treatment of a medical condition for which Benefits are available under the Plan, as identified in Section 6, Additional Coverage Details. 

 

	6.	treatment of congenitally missing (when the cells responsible for the formation of the tooth are absent from birth), malpositioned or supernumerary (extra) teeth, even
if part of a Congenital Anomaly such as cleft lip or cleft palate. 

 Devices, Appliances and Prosthetics 

 

	1.	devices used specifically as safety items or to affect performance in sports-related activities; 

 

	2.	orthotic appliances that straighten or re-shape a body part, including some types of braces (examples include foot orthotics, cranial banding and some types of braces,
including over-the-counter orthotic braces); 

  

	3.	the following items are excluded, even if prescribed by a Physician: 

  

	 	•	 	 blood pressure cuff/monitor; 

  

	 	•	 	 enures is alarm; 

  

	 	•	 	 home coagulation testing equipment; 

  

	 	•	 	 non-wearable external defibrillator; 

  
  

			
	 54
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	 	•	 	 trusses; 

  

	 	•	 	 ultrasonic nebulizers; 

  

	 	•	 	 ventricular assist devices; 

  

	4.	the repair and replacement of prosthetic devices when damaged due to misuse, malicious breakage or gross neglect; 

 

	5.	the replacement of lost or stolen prosthetic devices; 

  

	6.	devices and computers to assist in communication and speech except for speech aid prosthetics and tracheo-esophageal voice prosthetics; and 

 

	7.	oral appliances for snoring. 

 Drugs (The
exclusions listed below apply to the medical portion of the Plan only. Prescription Drug coverage is excluded under the medical plan because it is a separate benefit). 

 

	1.	prescription drugs for outpatient use that are filled by a prescription order or refill; 

 

	2.	self-injectable medications (This exclusion does not apply to medications which, due to their characteristics, as determined by UnitedHealthcare, must typically be
administered or directly supervised by a qualified provider or licensed/certified health professional in an outpatient setting); 

  

	3.	growth hormone therapy; 

  

	4.	non-injectable medications given in a Physician’s office except as required in an Emergency and consumed in the Physician’s office; and

  

	5.	over the counter drugs and treatments. 

Experimental or Investigational or Unproven Services 
  

	1.	Experimental or Investigational Services or Unproven Services, unless the Plan has agreed to cover them as defined in Section 14, Glossary.

 This exclusion applies even if Experimental or Investigational Services or Unproven Services, treatments,
devices or pharmacological regimens are the only available treatment options for your condition. 
 Foot Care 

 

	1.	routine foot care, except when needed for severe systemic disease or preventive foot care for Covered Persons with diabetes for which Benefits are provided as described
under Diabetes Services in Section 6, Additional Coverage Details. Routine foot care services that are not covered include: 

  

	 	•	 	 cutting or removal of corns and calluses; 

  

	 	•	 	 nail trimming or cutting; and 

  
  

			
	 55
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	 	•	 	 debriding (removal of dead skin or underlying tissue); 

 

	2.	hygienic and preventive maintenance foot care. Examples include: 

  

	 	•	 	 cleaning and soaking the feet; 

  

	 	•	 	 applying skin creams in order to maintain skin tone; and other services that are performed when there is not a localized Sickness, Injury or symptom
involving the foot; 

 This exclusion does not apply to preventive foot care for Covered Persons who are at
risk of neurological or vascular disease arising from diseases such as diabetes. 
  

	3.	treatment of flat feet; 

  

	4.	shoe inserts; 

  

	5.	arch supports; 

  

	6.	shoes (standard or custom), lifts and wedges; and 

  

	7.	shoe orthotics. 

 Medical Supplies and
Equipment 
  

	1.	prescribed or non-prescribed medical and disposable supplies. Examples include elastic stockings, ace bandages, diabetic strips, and syringes; 

This exclusion does not apply to: 
  

	 	•	 	 Disposable supplies necessary for the effective use of Durable Medical Equipment for which Benefits are provided as 

 

	 	•	 	 described under Durable Medical Equipment in this SPD. 

 

	 	•	 	 Diabetic supplies for which Benefits are provided as described under Diabetes Services in the SPD. 

 

	 	•	 	 Ostomy bags and related supplies for which Benefits are provided as described under Ostomy Supplies in this SPD and 

 

	 	•	 	 Urinary catheters and Ostomy bags and related supplies. 

 

	2.	tubings under Du, nasal cannulas, connectors and masks except when used with Durable Medical Equipment as described rable Medical Equipment in this SPD;

  

	3.	the repair and replacement of Durable Medical Equipment when damaged due to misuse, malicious breakage or gross neglect as described under Durable Medical Equipment in
this SPD; 

  

	4.	the replacement of lost or stolen Durable Medical Equipment as described under Durable Medical Equipment in this SPD; and 

  
  

			
	 56
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	5.	deodorants, filters, lubricants, tape, appliance clears, adhesive, adhesive remover or other items that are not specifically identified in Section 6, Additional
Coverage Details. 

 Mental Health/Substance Abuse 

 

	1.	inpatient, intermediate or outpatient care services that were not pre-authorized by the Mental Health/Substance Abuse (MH/SA) Administrator; 

 

	2.	services performed in connection with conditions not classified in the current edition of the American Psychiatric Association’s Diagnostic and Statistical
Manual of Mental Disorders; 

  

	3.	services that extend beyond the period necessary for short-term evaluation, diagnosis, treatment or crisis intervention; 

 

	4.	treatment for insomnia, other sleep disorders, neurological disorders and other disorders with a known physical basis; 

 

	5.	treatment for conduct and impulse control disorders, personality disorders, paraphilias (sexual behavior that is considered deviant or abnormal) and other Mental
Illnesses that will not substantially improve beyond the current level of functioning, or that are not subject to favorable modification or management according to prevailing national standards of clinical practice, as determined by the MH/SA
Administrator; 

  

	6.	services utilizing methadone, L.A.A.M. (1-Alpha-Acetyl-Methadol), Cyclazocine, or their equivalents as maintenance treatment for drug addiction;

  

	7.	treatment provided in connection with involuntary commitments, police detentions and other similar arrangements, unless pre-authorized by the MH/SA Administrator;

  

	8.	residential treatment services; 

  

	9.	MH/SA treatment of autism; 

  

	10.	routine use of psychological testing without specific authorization; 

  

	11.	pastoral counseling; and 

  

	12.	services and supplies for the diagnosis or treatment of Mental Illness, alcoholism or substance abuse disorders that, in the reasonable judgment of the MH/SA
Administrator, typically do not result in outcomes demonstrably better than other available treatment alternatives that are less intensive or more cost effective, or are not consistent with: 

 

	 	•	 	 prevailing national standards of clinical practice for the treatment of such conditions; 

 

	 	•	 	 prevailing professional research demonstrating that the services or supplies will have a measurable and beneficial health outcome; or

  

	 	•	 	 the MH/SA Administrator’s level of care guidelines as modified from time to time. 

  
  

			
	 57
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 The MH/SA Administrator may consult with professional clinical consultants, peer review
committees or other appropriate sources for recommendations and information regarding whether a service or supply meets any of these criteria. 

Nutrition 
  

	1.	nutritional or cosmetic therapy using high dose or mega quantities of vitamins, minerals or elements, and other nutrition based therapy; 

 

	2.	nutritional counseling for either individuals or groups, except as defined under Nutritional Counseling in Section 6, Additional Coverage Details;

  

	3.	food of any kind. Foods that are not covered include: 

  

	 	•	 	 enteral feedings and other nutritional and electrolyte formulas, including infant formula and donor breast milk, even if they are the only source of
nutrition or even if they are specifically created to treat inborn errors of metabolism such as phenylketonuria (PKU) – infant formula available over the counter is always excluded; 

 

	 	•	 	 foods to control weight, treat obesity (including liquid diets), lower cholesterol or control diabetes; 

 

	 	•	 	 oral vitamins and minerals; 

  

	 	•	 	 meals you can order from a menu, for an additional charge, during an Inpatient Stay; and 

 

	 	•	 	 other dietary and electrolyte supplements; and 

  

	4.	health education classes unless offered by UnitedHealthcare or its affiliates, including but not limited to asthma, smoking cessation, and weight control classes.

 Personal Care, Comfort or Convenience 
  

	1.	television; 

  

	2.	telephone; 

  

	3.	beauty/barber service; 

  

	4.	guest service; 

  

	5.	supplies, equipment and similar incidentals for personal comfort. Examples include: 

 

	 	•	 	 air conditioners; 

  

	 	•	 	 air purifiers and filters; 

  

	 	•	 	 batteries and battery chargers; 

  

	 	•	 	 dehumidifiers and humidifiers; 

  

	 	•	 	 ergonomically correct chairs; 

  

	 	•	 	 non-Hospital beds, comfort beds, motorized beds and mattresses; 

 

	 	•	 	 breast pumps; 

  

	 	•	 	 car seats; 

  

	 	•	 	 chairs, bath chairs, feeding chairs, toddler chairs, chair lifts, recliners; 

  
  

			
	 58
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	 	•	 	 electric scooters; 

  

	 	•	 	 exercise equipment and treadmills; 

  

	 	•	 	 hot tubs, Jacuzzis, saunas and whirlpools; 

  

	 	•	 	 medical alert systems; 

  

	 	•	 	 music devices; 

  

	 	•	 	 personal computers; 

  

	 	•	 	 pillows; 

  

	 	•	 	 power-operated vehicles; 

  

	 	•	 	 radios; 

  

	 	•	 	 strollers; 

  

	 	•	 	 safety equipment; 

  

	 	•	 	 vehicle modifications such as van lifts; 

  

	 	•	 	 video players; and 

  

	 	•	 	 home modifications to accommodate a health need (including, but not limited to, ramps, swimming pools, elevators, handrails, and stair glides).

 Physical Appearance 
  

	1.	Cosmetic Procedures, as defined in Section 14, Glossary, are excluded from coverage. Examples include: 

 

	 	•	 	 liposuction or removal of fat deposits considered undesirable, including fat accumulation under the male breast and nipple;

  

	 	•	 	 pharmacological regimens; 

  

	 	•	 	 nutritional procedures or treatments; 

  

	 	•	 	 tattoo or scar removal or revision procedures (such as salabrasion, chemosurgery and other such skin abrasion procedures);

  

	 	•	 	 hair removal or replacement by any means; 

  

	 	•	 	 treatments for skin wrinkles or any treatment to improve the appearance of the skin; 

 

	 	•	 	 treatment for spider veins; 

  

	 	•	 	 skin abrasion procedures performed as a treatment for acne; 

 

	 	•	 	 treatments for hair loss; 

  

	 	•	 	 varicose vein treatment of the lower extremities, when it is considered cosmetic; and 

 

	 	•	 	 replacement of an existing intact breast implant if the earlier breast implant was performed as a Cosmetic Procedure. 

 

	2.	breast reduction surgery that is determined to be a Cosmetic Procedure. 

 This exclusion does not apply to breast reduction surgery which the Claims Administrator determines is requested to treat a physiologic functional impairment or to coverage required by the Women’s
Health and Cancer Right’s Act of 1998 for which Benefits are described under Reconstructive Procedures in Section 6, Additional Coverage Details; 
  

	3.	physical conditioning programs such as athletic training, bodybuilding, exercise, fitness, flexibility, health club memberships and programs, spa treatments, and
diversion or general motivation; 

  
  

			
	 59
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	4.	weight loss programs whether or not they are under medical supervision or for medical reasons, even if for morbid obesity; 

 

	5.	wigs regardless of the reason for the hair loss except for hair loss resulting from treatment of a malignancy, burns, or surgery, in which case the Plan pays for one
wig per covered person per Lifetime; and 

  

	6.	treatment of benign gynecomastia (abnormal breast enlargement in males). 

 Preexisting Conditions 
  

	1.	Benefits for the treatment of a Preexisting Condition are excluded until the earlier of the following: 

 

	 	•	 	 the date you have had Continuous Creditable Coverage for 12 months; or 

 

	 	•	 	 the date you have had Continuous Creditable Coverage for 18 months if you are a Late Enrollee. 

Preexisting Condition is defined in Section 14, Glossary. 

This exclusion does not apply to newborn children or newly adopted children. This exception for newborn and adopted children no longer
applies after the end of the first 63-day period during which the child has not had Continuous Creditable Coverage. 
 Procedures and
Treatments 
  

	1.	biofeedback; 

  

	2.	medical and surgical treatment of snoring, except when provided as a part of treatment for documented obstructive sleep apnea (a sleep disorder in which a person
regularly stops breathing for 10 seconds or longer); 

  

	3.	speech therapy to treat stuttering, stammering, or other articulation disorders; 

 

	4.	speech therapy, except when required for treatment of a speech impediment or speech dysfunction that results from Injury, stroke, cancer, a Congenital Anomaly or autism
spectrum disorders as identified under Rehabilitation Services – Outpatient Therapy and Speech Therapy for Children under Age Three in Section 6, Additional Coverage Details; 

 

	5.	a procedure or surgery to remove fatty tissue such as panniculectomy, abdominoplasty, thighplasty, brachioplasty, or mastopexy; 

 

	6.	excision or elimination of hanging skin on any part of the body (examples include plastic surgery procedures called abdominoplasty or abdominal panniculectomy and
brachioplasty); 

  

	7.	psychosurgery (lobotomy); 

  

	8.	treatment of tobacco dependency; 

  

	9.	chelation therapy, except to treat heavy metal poisoning; 

  
  

			
	 60
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	10.	Chiropractic Treatment to treat a condition unrelated to spinal manipulation and ancillary physiologic treatment rendered to restore/improve motion, reduce pain and
improve function, alignment of the vertebral column, such as asthma or allergies; 

  

	11.	physiological modalities and procedures that result in similar or redundant therapeutic effects when performed on the same body region during the same visit or office
encounter; 

  

	12.	sex transformation operations; 

  

	13.	the following treatments for obesity: 

  

	 	•	 	 non-surgical treatment, even if for morbid obesity; and 

 

	 	•	 	 surgical treatment of obesity unless there is a diagnosis of morbid obesity as described under Obesity Surgery in Section 6, Additional
Coverage Details; 

  

	14.	medical and surgical treatment of hyperhidrosis (excessive sweating); 

  

	15.	services for the evaluation and treatment of temporomandibular joint syndrome (TMJ), when the services are considered medical or dental in nature, including oral
appliances, surface electromyography; Doppler analysis; vibration analysis; computerized mandibular scan or jaw tracking; craniosacral therapy; orthodontics; occlusal adjustment; dental restorations; 

 

	16.	diagnosis or treatment of the jawbones, including orthognathic surgery (procedure to correct underbite or overbite), jaw alignment and treatment for the
temporomandibular joint, except as treatment of obstructive sleep apnea; and 

  

	17.	upper and lower jawbone surgery except as required for direct treatment of acute traumatic Injury, dislocation, tumor or cancer. 

Providers 
 Services: 

 

	1.	performed by a provider who is a family member by birth or marriage, including your Spouse, brother, sister, parent or child; 

 

	2.	a provider may perform on himself or herself; 

  

	3.	performed by a provider with your same legal residence; 

  

	4.	ordered or delivered by a Christian Science practitioner; 

  

	5.	performed by an unlicensed provider or a provider who is operating outside of the scope of his/her license; 

 

	6.	foreign language and sign language interpreters; 

  
  

			
	 61
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	7.	provided at a diagnostic facility (Hospital or free-standing) without a written order from a provider; 

 

	8.	which are self-directed to a free-standing or Hospital-based diagnostic facility; and 

 

	9.	ordered by a provider affiliated with a diagnostic facility (Hospital or free-standing), when that provider is not actively involved in your medical care:

  

	 	•	 	 prior to ordering the service; or 

  

	 	•	 	 after the service is received. 

 This exclusion does not apply to mammography testing. 
 Reproduction 

 

	1.	health services and associated expenses for infertility treatments, including assisted reproductive technology, regardless of the reason for the treatment

 This exclusion does not apply to services required to treat or correct underlying causes of infertility.

  

	2.	storage and retrieval of all reproductive materials (examples include eggs, sperm, testicular tissue and ovarian tissue); 

 

	3.	surrogate parenting, donor eggs, donor sperm and host uterus; 

  

	4.	the reversal of voluntary sterilization; 

  

	5.	artificial reproductive treatments done for genetic or eugenic (selective breeding) purposes; 

 

	6.	prenatal, labor and delivery coverage for enrolled Dependent children even those that have Complications of Pregnancy as defined in Section 14, Glossary;

  

	7.	fetal surgery, unless as described under Congenital Heart Disease (CHD) Surgeries in Section 6, Additional Coverage Details;

  

	8.	fetal reduction surgery; 

  

	9.	elective surgical, non-surgical or drug induced Pregnancy termination; 

 This exclusion does not apply to treatment of a molar Pregnancy, ectopic Pregnancy, or missed abortion (commonly known as a miscarriage). 

 

	10.	services provided by a doula (labor aide); and 

  

	11.	parenting, pre-natal or birthing classes. 

Services Provided under Another Plan 

Services for which coverage is available: 
  

	1.	under another plan, except for Eligible Expenses payable as described in Section 10, Coordination of Benefits (COB); 

  
  

			
	 62
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	2.	under workers’ compensation, no-fault automobile coverage or similar legislation if you could elect it, or could have it elected for you; 

 

	3.	while on active military duty; and 

  

	4.	for treatment of military service-related disabilities when you are legally entitled to other coverage, and facilities are reasonably accessible.

 Transplants 
  

	1.	health services for organ and tissue transplants, except as identified under Transplantation Services in Section 6, Additional Coverage Details;

  

	2.	mechanical or animal organ transplants, except services related to the implant or removal of a circulatory assist device (a device that supports the heart while the
patient waits for a suitable donor heart to become available); and 

  

	3.	donor costs for organ or tissue transplantation to another person (these costs may be payable through the recipient’s benefit plan), except expenses incurred by
the donor who is not ordinarily covered under this plan according to Eligibility requirements will be covered expenses to the extent that such expenses are not payable by any other form of health coverage, including any governmental plan or
individual policy of health coverage, and provided the recipient is covered under this plan. The donor’s expense shall be applied to the recipient’s maximum benefit. In no event will benefits be payable in excess of the maximum benefit
still available to the recipient. 

 Travel 

 

	1.	health services provided in a foreign country, unless required as Emergency Health Services; and 

 

	2.	travel or transportation expenses, even if ordered by a Physician, except as identified under Travel and Lodging in Section 6, Additional Coverage
Details. Additional travel expenses related to Covered Health Services received from a Designated Facility or Designated Physician may be reimbursed at the Plan’s discretion. 

Types of Care 
  

	1.	Custodial Care as defined in Section 14, Glossary; 

  

	2.	Domiciliary Care, as defined in Section 14, Glossary; 

  

	3.	multi-disciplinary pain management programs provided on an inpatient basis; 

 

	4.	private duty nursing; 

  

	5.	respite care; 

  
  

			
	 63
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	6.	rest cures; 

  

	7.	services of personal care attendants; and 

  

	8.	work hardening (individualized treatment programs designed to return a person to work or to prepare a person for specific work). 

Vision and Hearing 
  

	1.	cochlear implants; 

  

	2.	implantable lenses used only to correct a refractive error (such as Intacs corneal implants); 

 

	3.	purchase cost and associated fitting charges for eyeglasses or contact lenses; 

 

	4.	purchase cost and associated fitting and testing charges for hearing aids, Bone Anchor Hearing Aids (BAHA) and all other hearing assistive devices; and

  

	5.	eye exercise therapy; and 

  

	6.	surgery and other related treatment that is intended to correct nearsightedness, farsightedness, presbyopia and astigmatism including, but not limited to, procedures
such as laser and other refractive eye surgery and radial keratotomy. 

 All Other Exclusions 

 

	1.	autopsies and other coroner services and transportation services for a corpse; 

 

	2.	charges for: 

  

	 	•	 	 missed appointments; 

  

	 	•	 	 room or facility reservations; 

  

	 	•	 	 completion of claim forms; or 

  

	 	•	 	 record processing; 

  

	3.	charges prohibited by federal anti-kickback or self-referral statutes; 

  

	4.	diagnostic tests that are: 

  

	 	•	 	 delivered in other than a Physician’s office or health care facility; and 

 

	 	•	 	 self-administered home diagnostic tests, including but not limited to HIV and Pregnancy tests; 

 

	5.	expenses for health services and supplies: 

  

	 	•	 	 that do not meet the definition of a Covered Health Service in Section 14, Glossary; 

 

	 	•	 	 that are received as a result of war or any act of war, whether declared or undeclared, while part of any armed service force of any country;

  
  

			
	 64
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	 	•	 	 that are received after the date your coverage under this Plan ends, including health services for medical conditions which began before the date your
coverage under the Plan ends; 

  

	 	•	 	 for which you have no legal responsibility to pay, or for which a charge would not ordinarily be made in the absence of coverage under this Benefit
Plan; or 

  

	 	•	 	 that exceed Eligible Expenses or any specified limitation in this SPD. 

 

	6.	long term (more than 30 days) storage of blood, umbilical cord or other material. Examples include cryopreservation of tissue, blood and blood products; and

  

	7.	physical, psychiatric or psychological exams, testing, vaccinations, immunizations or treatments when: 

 

	 	•	 	 required solely for purposes of career, education, sports or camp, travel, employment, insurance, marriage or adoption; or as a result of
incarceration; 

  

	 	•	 	 conducted for purposes of medical research; 

  

	 	•	 	 related to judicial or administrative proceedings or orders; or 

 

	 	•	 	 required to obtain or maintain a license of any type. 

  
  

			
	 65
	  	SECTION 8 - EXCLUSIONS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 9 - CLAIMS PROCEDURES 
 What this section includes: 
  

	•	 	 How Network and non-Network claims work; and 

  

	•	 	 What to do if your claim is denied, in whole or in part. 

 Network Benefits 
 In general, if you receive Covered Health Services from a Network
provider, UnitedHealthcare will pay the Physician or facility directly. If a Network provider bills you for any Covered Health Service other than your Copay or Coinsurance, please contact the provider or call UnitedHealthcare at the phone number on
your ID card for assistance. 
 Keep in mind, you are responsible for meeting the Annual Deductible and paying any Copay or Coinsurance owed to
a Network provider at the time of service, or when you receive a bill from the provider. 
 Non-Network Benefits 

If you receive a bill for Covered Health Services from a non-Network provider, you (or the provider if they prefer) must send the bill to UnitedHealthcare
for processing. To make sure the claim is processed promptly and accurately, a completed claim form must be attached and mailed to UnitedHealthcare at the address on the back of your ID card. 
 If Your Provider Does Not File Your Claim 
 You can obtain a claim form by visiting
www.myuhc.com, calling the toll-free number on your ID card or contacting Human Resources. If you do not have a claim form, simply attach a brief letter of explanation to the bill, and verify that the bill contains the information listed
below. If any of these items are missing from the bill, you can include them in your letter: 
  

	•	 	 your name and address; 

  

	•	 	 the patient’s name, age and relationship to the Participant; 

 

	•	 	 the number as shown on your ID card; 

  

	•	 	 the name, address and tax identification number of the provider of the service(s); 

 

	•	 	 a diagnosis from the Physician; 

  

	•	 	 the date of service; 

  

	•	 	 an itemized bill from the provider that includes: 

  

	 	•	 	 the Current Procedural Terminology (CPT) codes; 

  

	 	•	 	 a description of, and the charge for, each service; 

  

	 	•	 	 the date the Sickness or Injury began; and 

  
  

			
	 66
	  	SECTION 9 - CLAIMS PROCEDURES

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	 	•	 	 a statement indicating either that you are, or you are not, enrolled for coverage under any other health insurance plan or program. If you are enrolled
for other coverage you must include the name and address of the other carrier(s). 

 Failure to provide all the information
listed above may delay any reimbursement that may be due you. 
 After UnitedHealthcare has processed your claim, you will receive payment for
Benefits that the Plan allows. It is your responsibility to pay the non-Network provider the charges you incurred, including any difference between what you were billed and what the Plan paid. 

UnitedHealthcare will pay Benefits to you unless: 
  

	•	 	 the provider notifies UnitedHealthcare that you have provided signed authorization to assign Benefits directly to that provider; or

  

	•	 	 you make a written request for the non-Network provider to be paid directly at the time you submit your claim. 

UnitedHealthcare will only pay Benefits to you or, with written authorization by you, your provider, and not to a third party, even if your provider has
assigned Benefits to that third party. 
 Health Statements 
 Each month in which UnitedHealthcare processes at least one claim for you or a covered Dependent, you will receive a Health Statement in the mail. Health Statements make it easy for you to manage your
family’s medical costs by providing claims information in easy-to-understand terms. 
 If you would rather track claims for yourself and
your covered Dependents online, you may do so at www.myuhc.com. You may also elect to discontinue receipt of paper Health Statements by making the appropriate selection on this site. 
 Explanation of Benefits (EOB) 
 You may request that UnitedHealthcare send you a paper copy
of an Explanation of Benefits (EOB) after processing the claim. The EOB will let you know if there is any portion of the claim you need to pay. If any claims are denied in whole or in part, the EOB will include the reason for the denial or partial
payment. If you would like paper copies of the EOBs, you may call the toll-free number on your ID card to request them. You can also view and print all of your EOBs online at www.myuhc.com. See Section 14, Glossary for the
definition of Explanation of Benefits. 

  
  

			
	 67
	  	SECTION 9 - CLAIMS PROCEDURES

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Important - Timely Filing of Claims 

All Network claim forms must be submitted within 12 months after the date of service. Otherwise, the Plan will not pay any Benefits
for that Eligible Expense, or Benefits will be reduced, as determined by Kansas City Life Insurance Company. This 12-month requirement does not apply if you are legally incapacitated. All Non-Network Claims must be filed no later than
March 31st following the close of the plan year. If
your claim relates to an Inpatient Stay, the date of service is the date your Inpatient Stay ends. 
 Claim Denials and Appeals

 If Your Claim is Denied 
 If a claim for Benefits is denied in part or in whole, you may call UnitedHealthcare at the number on your ID card before requesting a formal appeal. If UnitedHealthcare cannot resolve the issue to your
satisfaction over the phone, you have the right to file a formal appeal as described below. 
 How to Appeal a Denied Claim

 If you wish to appeal a denied pre-service request for Benefits or post-service claim as described below, you or your authorized
representative must submit your appeal in writing within 180 days of receiving the denial. This written communication should include: 
  

	•	 	 the patient’s name and ID number as shown on the ID card; 

 

	•	 	 the provider’s name; 

  

	•	 	 the date of medical service; 

  

	•	 	 the reason you disagree with the denial; and 

  

	•	 	 any documentation or other written information to support your request. 

 You or your enrolled Dependent may send a written request for an appeal to: 
 UnitedHealthcare -
Appeals 
 P.O. Box 30432 
 Salt Lake
City, UT 84130-0432 
 For Urgent Care requests for Benefits that have been denied, you or your provider can call UnitedHealthcare at the
toll-free number on your ID card to request an appeal. 
 Types of claims 
 The timing of the claims appeal process is based on the type of claim you are appealing. If you wish to appeal a claim, it helps to understand whether it is an: 

 

	•	 	 urgent care request for Benefits; 

  

	•	 	 pre-service request for Benefits; 

  

	•	 	 post-service claim; or 

  

	•	 	 concurrent claim. 

  
  

			
	 68
	  	SECTION 9 - CLAIMS PROCEDURES

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Review of an Appeal 
 UnitedHealthcare will conduct a full and fair review of your appeal. The appeal may be reviewed by: 
  

	•	 	 an appropriate individual(s) who did not make the initial benefit determination; and 

 

	•	 	 a health care professional with appropriate expertise who was not consulted during the initial benefit determination process.

 Once the review is complete, if UnitedHealthcare upholds the denial, you will receive a written explanation of the reasons
and facts relating to the denial. 
 Filing a Second Appeal 
 Your Plan offers two levels of appeal. If you are not satisfied with the first level appeal decision, you have the right to request a second level appeal from Kansas City Life Insurance Company within 60
days from receipt of the first level appeal determination. Kansas City Life Insurance Company must notify you of the appeal determination within 15 days after receiving the completed appeal for a pre-service denial and 30 days after receiving the
completed post-service appeal. 
 Note: Upon written request and free of charge, any Covered Persons may examine documents
relevant to their claim and/or appeals and submit opinions and comments. Kansas City Life Insurance Company will review all claims in accordance with the rules established by the U.S. Department of Labor. Kansas City Life Insurance Company’s
decision will be final. 
 Voluntary External Review 
 If, after exhausting the two levels of appeal, you are not satisfied with the final determination, you may choose to participate in the voluntary external review program. This program only applies if the
claim denial is based on: 
  

	•	 	 clinical reasons; or 

  

	•	 	 the exclusions for Experimental or Investigational Services or Unproven Services. 

The voluntary external review program is not available if the claim denial is based on explicit benefit exclusions or defined benefit limits. Contact
UnitedHealthcare at the toll-free number on your ID card for more information. 
 Timing of Appeals Determinations 

Separate schedules apply to the timing of claims appeals, depending on the type of claim. There are three types of claims: 

 

	•	 	 Urgent Care request for Benefits - a request for Benefits provided in connection with Urgent Care services, as defined in Section 14,
Glossary; 

  

	•	 	 Pre-Service request for Benefits - a request for Benefits which the Plan must approve or in which you must notify UnitedHealthcare before non-Urgent
Care is provided; and 

  

	•	 	 Post-Service - a claim for reimbursement of the cost of non-Urgent Care that has already been provided. 

  
  

			
	 69
	  	SECTION 9 - CLAIMS PROCEDURES

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 The tables below describe the time frames which you and UnitedHealthcare are required to follow.

  

			
	  
 Urgent Care Request for Benefits*
  

	  
 Type of Request for Benefits or Appeal
  
	 	 Timing

 

	  
 If your request
for Benefits is incomplete, UnitedHealthcare must notify you within:
  
	 	
24 hours
  

	  
 You must then provide completed request for Benefits information to UnitedHealthcare within:
  
	 	  
 48 hours after
 receiving notice

 

	  
 If UnitedHealthcare denies your initial request for Benefits, they must notify you of the denial:
  

	  

•  if the initial request for Benefits is complete, within:

 
	 	 72 hours

 

	  
 •  after receiving the completed request for Benefits (if the initial request for Benefits is incomplete), within:

 
	 	48 hours
	You must appeal the request for Benefits denial no later than:	 	  
 180 days after
 receiving the denial

 

	UnitedHealthcare must notify you of the appeal decision within:	 	  

72 hours after
 receiving the appeal
  

  

	*	You do not need to submit Urgent Care appeals in writing. You should call UnitedHealthcare as soon as possible to appeal an Urgent Care request for Benefits.

  

			
	  
 Pre-Service Request for Benefits
  

	  
 Type of Request for Benefits or Appeal
  
	  	  
 Timing
  

	  
 If your request
for Benefits is filed improperly, UnitedHealthcare must notify you within:
  
	  	5 days
	  
 If your request for Benefits is incomplete, UnitedHealthcare must notify you within:
  
	  	  
 15 days
  

	  
 You must then
provide completed request for Benefits information to UnitedHealthcare within:
  
	  	  

45 days after receiving
 an extension notice*
  

  
  

			
	 70
	  	SECTION 9 - CLAIMS PROCEDURES

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

			
	  

Pre-Service Request for Benefits

 

	  

Type of Request for Benefits or Appeal

 
	 	
Timing
  

	  

If UnitedHealthcare denies your initial request for Benefits, they must notify you of the denial:

 

	  
 •  if the initial request for Benefits is complete, within:
  
	 	
15 days
  

	  

•  after receiving the completed request for Benefits (if the initial request for Benefits is
incomplete), within:
  
	 	  
 15 days
  

	You must appeal the request for Benefits denial no later than:	 	  

180 days after
 receiving the denial
  

	UnitedHealthcare must notify you of the first level appeal decision within:	 	  
 15 days after receiving
 the first level appeal

 

	You must appeal the first level appeal (file a second level appeal) within:	 	  

60 days after receiving
 the first level appeal
 decision

 

	Kansas City Life Insurance Company must notify you of the
second level appeal decision within:	 	  
 15 days after receiving
 the second level

appeal*
  

 

	*	UnitedHealthcare may require a one-time extension of no more than 15 days only if more time is needed due to circumstances beyond their control.

  

			
	  

Post-Service Claims
  

	  

Type of Claim or Appeal
	 	  

Timing
  

	  

If your claim is incomplete, UnitedHealthcare must notify you within:

 
	 	  
 30 days
  

	 You must then provide completed claim information to UnitedHealthcare
within:
	 	  

45 days after receiving
 an extension notice*
  

	  

If UnitedHealthcare denies your initial claim, they must notify you of the denial:

 

	  
 •  if the initial claim is complete, within:
  
	 	
30 days
  

	  

•  after receiving the completed claim (if the initial claim is incomplete), within:

 
	 	 30 days

 

	You must appeal the claim denial no later than:	 	  

180 days after
 receiving the denial
  

	UnitedHealthcare must notify you of the first level
appeal decision within:	 	  
 30 days after receiving
 the first level appeal

 

  
  

			
	 71
	  	SECTION 9 - CLAIMS PROCEDURES

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

			
	  

Post-Service Claims
  

	  

Type of Claim or Appeal
  
	 	  

Timing
  

	 You
must appeal the first level appeal (file a second level appeal) within:
	 	  
 60 days after receiving
 the first level appeal

decision
  

	Kansas City Life Insurance Company must notify you of the
second level appeal decision within:	 	  
 30 days after receiving
 the second level appeal

 

  

	*	UnitedHealthcare may be entitled to a one-time extension of no more than 15 days only if more time is needed due to circumstances beyond their control.

 Concurrent Care Claims 
 If an on-going course of treatment was previously approved for a specific period of time or number of treatments, and your request to extend the treatment is an Urgent Care request for Benefits as defined
above, your request will be decided within 24 hours, provided your request is made at least 24 hours prior to the end of the approved treatment. UnitedHealthcare will make a determination on your request for the extended treatment within 24 hours
from receipt of your request. 
 If your request for extended treatment is not made at least 24 hours prior to the end of the approved
treatment, the request will be treated as an Urgent Care request for Benefits and decided according to the timeframes described above. If an on-going course of treatment was previously approved for a specific period of time or number of treatments,
and you request to extend treatment in a non-urgent circumstance, your request will be considered a new request and decided according to post-service or pre-service timeframes, whichever applies. 

Limitation of Action 
 You cannot bring
any legal action against Kansas City Life Insurance Company or the Claims Administrator to recover reimbursement until 90 days after you have properly submitted a request for reimbursement as described in this section and all required reviews of
your claim have been completed. If you want to bring a legal action against Kansas City Life Insurance Company or the Claims Administrator, you must do so within three years from the expiration of the time period in which a request for reimbursement
must be submitted or you lose any rights to bring such an action against Kansas City Life Insurance Company or the Claims Administrator. 
 You
cannot bring any legal action against Kansas City Life Insurance Company or the Claims Administrator for any other reason unless you first complete all the steps in the appeal process described in this section. After completing that process, if you
want to bring a legal action against Kansas City Life Insurance Company or the Claims Administrator you must do so within three years of the date you are notified of our final decision on your appeal or you lose any rights to bring such an action
against Kansas City Life Insurance Company or the Claims Administrator. 

  
  

			
	 72
	  	SECTION 9 - CLAIMS PROCEDURES

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 10 - COORDINATION OF BENEFITS (COB) 

What this section includes: 
  

	•	 	 How your Benefits under this Plan coordinate with other medical plans; 

 

	•	 	 How coverage is affected if you become eligible for Medicare; and 

 

	•	 	 Procedures in the event the Plan overpays Benefits. 

 Coordination of Benefits (COB) applies to you if you are covered by more than one health benefits plan, including any one of the following: 

 

	•	 	 another employer sponsored health benefits plan; 

  

	•	 	 a medical component of a group long-term care plan, such as skilled nursing care; 

 

	•	 	 no-fault or traditional “fault” type medical payment benefits or personal injury protection benefits under an auto insurance policy;

  

	•	 	 medical payment benefits under any premises liability or other types of liability coverage; or 

 

	•	 	 Medicare or other governmental health benefit. 

 If coverage is provided under two or more plans, COB determines which plan is primary and which plan is secondary. The plan considered primary pays its benefits first, without regard to the possibility
that another plan may cover some expenses. Any remaining expenses may be paid under the other plan, which is considered secondary. The secondary plan may determine its benefits based on the benefits paid by the primary plan. 

Don’t forget to update your Dependents’ Medical Coverage Information 
 Avoid delays on your Dependent claims by updating your Dependent’s medical coverage information. Just log on to www.myuhc.com or call the toll-free number on your ID card to update your COB
information. You will need the name of your Dependent’s other medical coverage, along with the policy number. 
 Determining Which Plan
is Primary 
 If you are covered by two or more plans, the benefit payment follows the rules below in this order: 

 

	•	 	 this Plan will always be secondary to medical payment coverage or personal injury protection coverage under any auto liability or no-fault insurance
policy; 

  

	•	 	 when you have coverage under two or more medical plans and only one has COB provisions, the plan without COB provisions will pay benefits first;

  

	•	 	 a plan that covers a person as a Participant pays benefits before a plan that covers the person as a Dependent; 

 

	•	 	 if you are receiving COBRA continuation coverage under another employer plan, this Plan will pay Benefits first; 

  
  

			
	 73
	  	SECTION 10 - COORDINATION OF BENEFITS (COB)

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 your Dependent children will receive primary coverage from the parent whose birth date occurs first in a calendar year. If both parents have the same
birth date, the plan that pays benefits first is the one that has been in effect the longest. This birthday rule applies only if: 

  

	 	•	 	 the parents are married or living together whether or not they have ever been married and not legally separated; or 

 

	 	•	 	 a court decree awards joint custody without specifying that one party has the responsibility to provide health care coverage;

  

	•	 	 if two or more plans cover a Dependent child of divorced or separated parents and if there is no court decree stating that one parent is responsible
for health care, the child will be covered under the plan of: 

  

	 	•	 	 the parent with custody of the child; then 

  

	 	•	 	 the Spouse of the parent with custody of the child; then 

 

	 	•	 	 the parent not having custody of the child; then 

  

	 	•	 	 the Spouse of the parent not having custody of the child; 

 

	•	 	 plans for active Participants pay before plans covering laid-off or retired Participants; 

 

	•	 	 the plan that has covered the individual claimant the longest will pay first; The expenses must be covered in part under at least one of the plans; and

  

	•	 	 finally, if none of the above rules determines which plan is primary or secondary, the allowable expenses shall be shared equally between the plans
meeting the definition of Plan. In addition, this Plan will not pay more than it would have paid had it been the primary Plan. 

 The following examples illustrate how the Plan determines which plan pays first and which plan pays second. 
 Determining Primary and Secondary Plan – Examples 
 1) Let’s say you and your
Spouse both have family medical coverage through your respective employers. You are unwell and go to see a Physician. Since you’re covered as a Participant under this Plan, and as a Dependent under your Spouse’s plan, this Plan will pay
Benefits for the Physician’s office visit first. 
 2) Again, let’s say you and your Spouse both have family medical coverage through
your respective employers. You take your Dependent child to see a Physician. This Plan will look at your birthday and your Spouse’s birthday to determine which plan pays first. If you were born on June 11 and your Spouse was born on
May 30, your Spouse’s plan will pay first. 
 When This Plan is Secondary 

If this Plan is secondary, it determines the amount it will pay for a Covered Health Service by following the steps below. 

 

	•	 	 the Plan determines the amount it would have paid had it been the only plan involved. 

  
  

			
	 74
	  	SECTION 10 - COORDINATION OF BENEFITS (COB)

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 the Plan pays the entire difference between the allowable expense and the amount paid by the primary plan – as long as this amount is not more
than the Plan would have paid had it been the only plan involved. 

 The maximum combined payment you may receive from all
plans cannot exceed 100% of the total allowable expense. See the textbox below for the definition of allowable expense. 
 Determining the
Allowable Expense When This Plan is Secondary 
 When this Plan is secondary, the allowable expense is the primary plan’s Network
rate. If the primary plan bases its reimbursement on reasonable and customary charges, the allowable expense is the primary plan’s reasonable and customary charge. If both the primary plan and this Plan do not have a contracted rate, the
allowable expense will be the greater of the two plans’ reasonable and customary charges. 
 What is an allowable expense?

 For purposes of COB, an allowable expense is a health care expense that is covered at least in part by one of the health benefit plans
covering you. 
 When a Covered Person Qualifies for Medicare 
 Determining Which Plan is Primary 
 To the extent permitted by law, this Plan will
pay Benefits second to Medicare when you become eligible for Medicare, even if you don’t elect it. There are, however, Medicare-eligible individuals for whom the Plan pays Benefits first and Medicare pays benefits second: 

 

	•	 	 employees with active current employment status age 65 or older and their Spouses age 65 or older; and 

 

	•	 	 individuals with end-stage renal disease, for a limited period of time. 

 Determining the Allowable Expense When This Plan is Secondary 
 If this Plan is
secondary to Medicare, the Medicare approved amount is the allowable expense, as long as the provider accepts Medicare. If the provider does not accept Medicare, the Medicare limiting charge (the most a provider can charge you if they don’t
accept Medicare) will be the allowable expense. Medicare payments, combined with Plan Benefits, will not exceed 100% of the total allowable expense. 
 If you are eligible for, but not enrolled in, Medicare, and this Plan is secondary to Medicare, Benefits payable under this Plan will be reduced by the amount that would have been paid if you had been
enrolled in Medicare. 
 Medicare Cross-Over Program 
 The Plan offers a Medicare Cross-over Program for Medicare Part A claims. If you enroll for this program, you no longer have to file a separate claim with the Plan to receive secondary benefits for these
expenses. 

  
  

			
	 75
	  	SECTION 10 - COORDINATION OF BENEFITS (COB)

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Once the Medicare Part A carrier[s] have reimbursed your health care provider, the Medicare carrier will
electronically submit the necessary information to the Claims Administrator to process the balance of your claim under the provisions of this Plan. 
 To participate in the Medicare Cross-over Program, you must complete a special form authorizing this service and submit it to the Claims Administrator. Your Spouse also can enroll for this program, as
long as he or she is eligible for Medicare and this Plan is your only secondary medical coverage. 
 You can verify that the automated
cross-over is in place when your copy of the explanation of Medicare benefits (EOMB) states your claim has been forwarded to your secondary carrier. Until this message appears, you must continue to file secondary claims with the Claims
Administrator. 
 This cross-over process does not apply to expenses under Part B (Physician office visits) and DME Medicare expenses or
expenses that Medicare does not cover. You must continue to file claims for these expenses. 
 For information about enrollment or if you have
questions about the program, call the telephone number listed on the back of your ID card. 
 Right to Receive and Release Needed Information

 Certain facts about health care coverage and services are needed to apply these COB rules and to determine benefits payable under this
Plan and other plans. The Plan Administrator may get the facts needed from, or give them to, other organizations or persons for the purpose of applying these rules and determining benefits payable under this Plan and other plans covering the person
claiming benefits. 
 The Plan Administrator does not need to tell, or get the consent of, any person to do this. Each person claiming benefits
under this Plan must give UnitedHealthcare any facts needed to apply those rules and determine benefits payable. If you do not provide UnitedHealthcare the information needed to apply these rules and determine the Benefits payable, your claim for
Benefits will be denied. 
 Overpayment and Underpayment of Benefits 
 If you are covered under more than one medical plan, there is a possibility that the other plan will pay a benefit that UnitedHealthcare should have paid. If this occurs, the Plan may pay the other plan
the amount owed. 
 If the Plan pays you more than it owes under this COB provision, you should pay the excess back promptly. Otherwise, the
Company may recover the amount in the form of salary, wages, or benefits payable under any Company-sponsored benefit plans, including this Plan. The Company also reserves the right to recover any overpayment by legal action or offset payments on
future Eligible Expenses. 
 If the Plan overpays a health care provider, UnitedHealthcare reserves the right to recover the excess amount, by
legal action if necessary. 

  
  

			
	 76
	  	SECTION 10 - COORDINATION OF BENEFITS (COB)

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Refund of Overpayments 
 If Kansas City Life Insurance Company pays for Benefits for expenses incurred on account of a Covered Person, that Covered Person, or any other person or organization that was paid, must make a refund to
Kansas City Life Insurance Company if: 
  

	•	 	 all or some of the expenses were not paid by the Covered Person or did not legally have to be paid by the Covered Person; 

 

	•	 	 all or some of the payment Kansas City Life Insurance Company made exceeded the Benefits under the Plan; or 

 

	•	 	 all or some of the payment was made in error. 

 The refund equals the amount Kansas City Life Insurance Company paid in excess of the amount that should have paid under the Plan. If the refund is due from another person or organization, the Covered
Person agrees to help Kansas City Life Insurance Company get the refund when requested. 
 If the Covered Person, or any other person or
organization that was paid, does not promptly refund the full amount, Kansas City Life Insurance Company may reduce the amount of any future Benefits for the Covered Person that are payable under the Plan. The reductions will equal the amount of the
required refund. Kansas City Life Insurance Company may have other rights in addition to the right to reduce future Benefits. 

  
  

			
	 77
	  	SECTION 10 - COORDINATION OF BENEFITS (COB)

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 11 - SUBROGATION AND REIMBURSEMENT 

What this section includes: 
  

	•	 	 How your Benefits are impacted if you suffer a Sickness or Injury caused by a third party. 

The Plan has a right to subrogation and reimbursement, as defined below. 
 Right of Recovery 
 The Plan has the right to recover benefits it has paid on you or your
Dependent’s behalf that were: 
  

	•	 	 made in error; 

  

	•	 	 due to a mistake in fact; 

  

	•	 	 advanced during the time period of meeting the calendar year Deductible; or 

 

	•	 	 advanced during the time period of meeting the Out-of-Pocket Maximum for the calendar year. 

Benefits paid because you or your Dependent misrepresented facts are also subject to recovery. 
 If the Plan provides a Benefit for you or your Dependent that exceeds the amount that should have been paid, the Plan will: 
  

	•	 	 require that the overpayment be returned when requested, or 

 

	•	 	 reduce a future benefit payment for you or your Dependent by the amount of the overpayment. 

If the Plan provides an advancement of benefits to you or your Dependent during the time period of the Deductible and/or meeting the Out-of-Pocket
Maximum for the calendar year, the Plan will send you or your Dependent a monthly statement identifying the amount you owe with payment instructions. The Plan has the right to recover Benefits it has advanced by: 

 

	•	 	 submitting a reminder letter to you or a covered Dependent that details any outstanding balance owed to the Plan; and 

 

	•	 	 conducting courtesy calls to you or a covered Dependent to discuss any outstanding balance owed to the Plan. 

Right to Subrogation 
 The right to
subrogation means the Plan is substituted to and shall succeed to any and all legal claims that you may be entitled to pursue against any third party for Benefits that the Plan has paid. Subrogation applies when the Plan has paid on your behalf
Benefits for a Sickness or Injury for which a third party is considered responsible, e.g. an insurance carrier if you are involved in an auto accident. 

  
  

			
	 78
	  	SECTION 11 - SUBROGATION AND REIMBURSEMENT

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 The Plan shall be subrogated to, and shall succeed to, all rights of recovery from any or all third
parties, under any legal theory of any type, for 100 percent of any services and Benefits the Plan has paid on your behalf relating to any Sickness or Injury caused by any third party. 
 Right to Reimbursement 
 The right to reimbursement means that if a third party causes a
Sickness or Injury for which you receive a settlement, judgment, or other recovery, you must use those proceeds to fully return to the Plan 100% of any Benefits you received for that Sickness or Injury. 

Third Parties 
 The following persons and
entities are considered third parties: 
  

	•	 	 a person or entity alleged to have caused you to suffer a Sickness, Injury or damages, or who is legally responsible for the Sickness, Injury or
damages; 

  

	•	 	 Kansas City Life Insurance Company in workers’ compensation cases; or 

 

	•	 	 any person or entity who is or may be obligated to provide you with benefits or payments under: 

 

	 	•	 	 underinsured or uninsured motorist insurance; 

  

	 	•	 	 medical provisions of no-fault or traditional insurance (auto, homeowners or otherwise); 

 

	 	•	 	 workers’ compensation coverage; or 

  

	 	•	 	 any other insurance carrier or third party administrator. 

 Subrogation and Reimbursement Provisions 
 As a Covered Person, you agree to the following:

  

	•	 	 the Plan has a first priority right to receive payment on any claim against a third party before you receive payment from that third party.

  

	•	 	 the Plan’s subrogation and reimbursement rights apply to full and partial settlements, judgments, or other recoveries paid or payable to you or
your representative, no matter how those proceeds are captioned or characterized. Payments include, but are not limited to, economic, non-economic, and punitive damages. The Plan is not required to help you to pursue your claim for damages or
personal injuries, or pay any of your associated costs, including attorneys’ fees. No so-called “Fund Doctrine” or “Common Fund Doctrine” or “Attorney’s Fund Doctrine” shall defeat this right.

  

	•	 	 the Plan may enforce its subrogation and reimbursement rights regardless of whether you have been “made whole” (fully compensated for your
injuries and damages). 

  

	•	 	 you will cooperate with the Plan and its agents in a timely manner to protect its legal and equitable rights to subrogation and reimbursement,
including, but not limited to: 

  

	 	•	 	 complying with the terms of this section; 

  
  

			
	 79
	  	SECTION 11 - SUBROGATION AND REIMBURSEMENT

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	 	•	 	 providing any relevant information requested; 

  

	 	•	 	 signing and/or delivering documents at its request; 

  

	 	•	 	 appearing at medical examinations and legal proceedings, such as depositions or hearings; and 

 

	 	•	 	 obtaining the Plan’s consent before releasing any party from liability or payment of medical expenses. 

 

	•	 	 if you receive payment as part of a settlement or judgment from any third party as a result of a Sickness or Injury, and the Plan alleges some or all
of those funds are due and owed to it, you agree to hold those settlement funds in trust, either in a separate bank account in your name or in your attorney’s trust account. You agree that you will serve as a trustee over those funds to the
extent of the Benefits the Plan has paid. 

  

	•	 	 if the Plan incurs attorneys’ fees and costs in order to collect third party settlement funds held by you or your representative, the Plan has the
right to recover those fees and costs from you. 

  

	•	 	 you may not accept any settlement that does not fully reimburse the Plan, without its written approval. 

 

	•	 	 you will assign to the Plan all rights of recovery against third parties to the extent of Benefits the Plan has provided for a Sickness or Injury
caused by a third party. 

  

	•	 	 the Plan’s rights will not be reduced due to your own negligence. 

 

	•	 	 the Plan may file suit in your name and take appropriate action to assert its rights under this section. The Plan is not required to pay you part of
any recovery it may obtain from a third party, even if it files suit in your name. 

  

	•	 	 the provisions of this section apply to the parents, guardian, or other representative of a Dependent child who incurs a Sickness or Injury caused by a
third party. 

  

	•	 	 in case of your wrongful death, the provisions of this section apply to your estate, the personal representative of your estate, and your heirs.

  

	•	 	 your failure to cooperate with the Plan or its agents is considered a breach of contract. As such, the Plan has the right to terminate your Benefits,
deny future Benefits, take legal action against you, and/or set off from any future Benefits the value of Benefits the Plan has paid relating to any Sickness or Injury caused by any third party to the extent not recovered by the Plan due to you or
your representative not cooperating with the Plan. 

  

	•	 	 if a third party causes you to suffer a Sickness or Injury while you are covered under this Plan, the provisions of this section continue to apply,
even after you are no longer a Covered Person. 

  

	•	 	 the Plan has the authority and discretion to resolve all disputes regarding the interpretation of the language stated herein.

 Subrogation – Example 
 Suppose you are injured in a car accident that is not your fault, and you receive Benefits under the Plan to treat your injuries. Under subrogation, the Plan has the right to take legal action in your
name against the driver who caused the accident and that driver’s insurance carrier to recover the cost of those Benefits. 

  
  

			
	 80
	  	SECTION 11 - SUBROGATION AND REIMBURSEMENT

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 12 - WHEN COVERAGE ENDS 
 What this section includes: 
  

	•	 	 Circumstances that cause coverage to end; 

  

	•	 	 Extended coverage; and 

  

	•	 	 How to continue coverage after it ends. 

 Your entitlement to Benefits automatically ends on the date that coverage ends, even if you are hospitalized or are otherwise receiving medical treatment on that date. 

When your coverage ends, Kansas City Life Insurance Company will still pay claims for Covered Health Services that you received before your coverage
ended. However, once your coverage ends, Benefits are not provided for health services that you receive after coverage ended, even if the underlying medical condition occurred before your coverage ended. 

Your coverage under the Plan will end on the earliest of: 
  

	•	 	 the last day of the month your employment with the Company ends; 

 

	•	 	 the date the Plan ends; 

  

	•	 	 the last day of the month you stop making the required contributions; 

 

	•	 	 the last day of the month you are no longer eligible; 

 

	•	 	 the last day of the month UnitedHealthcare receives written notice from Kansas City Life Insurance Company to end your coverage, or the date requested
in the notice, if later; or 

  

	•	 	 the last day of the month you retire or are pensioned under the Plan, unless specific coverage is available for retired or pensioned persons and you
are eligible for that coverage. 

 Coverage for your eligible Dependents will end on the earliest of: 

 

	•	 	 the date your coverage ends; 

  

	•	 	 the last day of the month you stop making the required contributions; 

 

	•	 	 the last day of the month UnitedHealthcare receives written notice from Kansas City Life Insurance Company to end your coverage, or the date requested
in the notice, if later; 

  

	•	 	 the last day of the year your Dependent child no longer qualifies as a Dependent under this Plan; or 

 

	•	 	 the last day of the month your Dependents no longer qualify as Dependents under this Plan. 

The Plan will provide written notice to you that your coverage has ended if any of the following occur: 

 

	•	 	 you permit an unauthorized person to use your ID card or you use another person’s ID card; 

  
  

			
	 81
	  	SECTION 12 - WHEN COVERAGE ENDS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 you knowingly give UnitedHealthcare false material information including, but not limited to, false information relating to another person’s
eligibility or status as a Dependent; 

  

	•	 	 you commit an act of physical or verbal abuse that imposes a threat to Kansas City Life Insurance Company’s staff, UnitedHealthcare’s staff,
a provider or another Covered Person; or 

  

	•	 	 you violate any terms of the Plan. 

 Note: Kansas City Life Insurance Company has the right to demand that you pay back Benefits Kansas City Life Insurance Company paid to you, or paid in your name, during the time you were
incorrectly covered under the Plan. After the first two years, Kansas City Life Insurance Company can only demand that you pay back these Benefits if the written application contained a fraudulent misstatement. 

Other Events Ending Your Coverage 
 Your
coverage may also end when any of the following happen. If your coverage is terminated for any of the below reasons you will be provided written notice that coverage has ended on the date the Plan Administrator identifies in the notice. 

 

	•	 	 Fraud, Misrepresentation or False Information - occurs when there has been fraud or misrepresentation, or the Participant knowingly gave
UnitedHealthcare or Kansas City Life Insurance Company false material information. Examples include false information relating to another person’s eligibility or status as a Dependent.UnitedHealthcare reserves the right to demand that you pay
back Benefits Kansas City Life Insurance Company paid to you, or paid in your name, during the time you were incorrectly covered under the Plan. 

  

	•	 	 Material Violation – occurs when there was a material violation of the terms of the Plan. 

 

	•	 	 Threatening Behavior – occurs when you have committed acts of physical or verbal abuse that pose a threat to Kansas City Life Insurance
Company’s staff or UnitedHealthcare’s staff. 

 Coverage for a Disabled Child 

If an unmarried enrolled Dependent child with a mental or physical disability reaches an age when coverage would otherwise end, the Plan will continue to
cover the child, as long as: 
  

	•	 	 the child is unable to be self-supporting due to a mental or physical handicap or disability; 

 

	•	 	 the child depends mainly on you for support; 

  

	•	 	 you provide to Kansas City Life Insurance Company proof of the child’s incapacity and dependency within 31 days of the date coverage would have
otherwise ended because the child reached a certain age; and 

  
  

			
	 82
	  	SECTION 12 - WHEN COVERAGE ENDS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 you provide proof, upon Kansas City Life Insurance Company’s request, that the child continues to meet these conditions.

 The proof might include medical examinations at Kansas City Life Insurance Company’s expense. However, you will not be
asked for this information more than once a year. If you do not supply such proof within 31 days, the Plan will no longer pay Benefits for that child. 
 Coverage will continue, as long as the enrolled Dependent is incapacitated and dependent upon you, unless coverage is otherwise terminated in accordance with the terms of the Plan. 

Continuing Coverage Through COBRA 
 If
you lose your Plan coverage, you may have the right to extend it under the Consolidated Budget Reconciliation Act of 1985 (COBRA), as defined in Section 14, Glossary. 
 Continuation coverage under COBRA is available only to Plans that are subject to the terms of COBRA. You can contact your Plan Administrator to determine if Kansas City Life Insurance Company is subject
to the provisions of COBRA. 
 Continuation Coverage under Federal Law (COBRA) 

Much of the language in this section comes from the federal law that governs continuation coverage. You should call your Plan Administrator if you have
questions about your right to continue coverage. 
 In order to be eligible for continuation coverage under federal law, you must meet the
definition of a “Qualified Beneficiary”. A Qualified Beneficiary is any of the following persons who were covered under the Plan on the day before a qualifying event: 

 

	•	 	 a Participant; 

  

	•	 	 a Participant’s enrolled Dependent, including with respect to the Participant’s children, a child born to or placed for adoption with the
Participant during a period of continuation coverage under federal law; or 

  

	•	 	 a Participant’s former Spouse. 

 Qualifying Events for Continuation Coverage under COBRA 
 The following table
outlines situations in which you may elect to continue coverage under COBRA for yourself and your Dependents, and the maximum length of time you can receive continued coverage. These situations are considered qualifying events. 

 

							
	 If
Coverage Ends Because of
 the Following Qualifying

Events:
	  	  
 You May Elect COBRA:
  

	  	  For Yourself    	  	    For Your Spouse    	  	  
 For Your
   Child(ren)  

 

	  

Your work hours are reduced
  
	  	
18 months
  
	  	
18 months
  
	  	  

18 months

 

  
  

			
	 83
	  	SECTION 12 - WHEN COVERAGE ENDS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

							
	 If
Coverage Ends Because of
 the Following Qualifying

Events:
	  	  
 You May Elect COBRA:
  

	  	  For Yourself    	  	    For Your Spouse    	  	  
 For Your
   Child(ren)  

 

	  
 Your employment terminates for any reason (other than gross misconduct) 
  
	  	  
 18 months
  
	  	  
 18 months
  
	  	  
 18 months
  

	  
 You or your family member become eligible for Social Security disability benefits at any time within the first 60 days of losing coverage1  
  
	  	 29 months

 
	  	 29 months

 
	  	 29 months

 

	  
 You die
  
	  	 N/A

 
	  	 36 months

 
	  	 36 months

 

	  
 You divorce (or legally separate)
  
	  	 N/A

 
	  	 36 months

 
	  	 36 months

 

	  
 Your child is no longer an eligible family member (e.g., reaches the maximum age limit)
  
	  	 N/A

 
	  	 N/A

 
	  	 36 months

 

	  
 You become entitled to Medicare
  
	  	 N/A

 
	  	 See table below

 
	  	 See table below

 

	  

Kansas City Life Insurance Company files for bankruptcy under Title 11, United States Code.2
  
	  	 36
months
  
	  	 36 months3

 
	  	
36
months3

 

  

	1	 Subject to the following conditions: (i) notice of the disability must be provided within the latest of 60 days after a). the determination of the
disability, b). the date of the qualifying event, c). the date the Qualified Beneficiary would lose coverage under the Plan, and in no event later than the end of the first 18 months; (ii) the Qualified Beneficiary must agree to pay any
increase in the required premium for the additional 11 months over the original 18 months; and (iii) if the Qualified Beneficiary entitled to the 11 months of coverage has non-disabled family members who are also Qualified Beneficiaries, then
those non-disabled Qualified Beneficiaries are also entitled to the additional 11 months of continuation coverage. Notice of any final determination that the Qualified Beneficiary is no longer disabled must be provided within 30 days of such
determination. Thereafter, continuation coverage may be terminated on the first day of the month that begins more than 30 days after the date of that determination. 

	2	 This is a qualifying event for any Retired Participant and his or her enrolled Dependents if there is a substantial elimination of coverage within one
year before or after the date the bankruptcy was filed. 

	3	 From the date of the Participant’s death if the Participant dies during the continuation coverage. 

  
  

			
	 84
	  	SECTION 12 - WHEN COVERAGE ENDS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 How Your Medicare Eligibility Affects Dependent COBRA Coverage 

The table below outlines how your Dependents’ COBRA coverage is impacted if you become entitled to Medicare. 

 

					
	If Dependent Coverage Ends When:	 	 	 	  
     You May Elect   
    COBRA Dependent    
    Coverage For Up 
To:      
  

	  
 You become entitled to Medicare and don’t experience any additional qualifying events
  
	 	 	 	  
 18 months
  

	  
 You become entitled to Medicare, after which you experience a second qualifying event* before the initial 18-month period expires

 
	 	 	 	36 months
	  

You experience a qualifying event*, after which you become entitled to Medicare before the initial 18-month period expires; and, if absent this initial
qualifying event, your Medicare entitlement would have resulted in loss of Dependent coverage under the Plan
  
	 	 	 	36 months

 

	*	Your work hours are reduced or your employment is terminated for reasons other than gross misconduct. 

Getting Started 
 You will be
notified by mail if you become eligible for COBRA coverage as a result of a reduction in work hours or termination of employment. The notification will give you instructions for electing COBRA coverage, and advise you of the monthly cost. Your
monthly cost is the full cost, including both Participant and Employer costs, plus a 2% administrative fee or other cost as permitted by law. 

You will have up to 60 days from the date you receive notification or 60 days from the date your coverage ends to elect COBRA coverage, whichever is
later. You will then have an additional 45 days to pay the cost of your COBRA coverage, retroactive to the date your Plan coverage ended. 

During the 60-day election period, the Plan will, only in response to a request from a provider, inform that provider of your right to elect COBRA
coverage, retroactive to the date your COBRA eligibility began. 
 While you are a participant in the medical Plan under COBRA, you have the
right to change your coverage election: 
  

	•	 	 during Open Enrollment; and 

  

	•	 	 following a change in family status, as described under Changing Your Coverage in Section 2, Introduction.

  
  

			
	 85
	  	SECTION 12 - WHEN COVERAGE ENDS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Notification Requirements 
 If your covered Dependents lose coverage due to divorce, legal separation, or loss of Dependent status, you or your Dependents must notify the Plan Administrator within 60 days of the latest of:

  

	•	 	 the date of the divorce, legal separation or an enrolled Dependent’s loss of eligibility as an enrolled Dependent; 

 

	•	 	 the date your enrolled Dependent would lose coverage under the Plan; or 

 

	•	 	 the date on which you or your enrolled Dependent are informed of your obligation to provide notice and the procedures for providing such notice.

 You or your Dependents must also notify the Plan Administrator when a qualifying event occurs that will extend continuation
coverage. 
 If you or your Dependents fail to notify the Plan Administrator of these events within the 60 day period, the Plan Administrator is
not obligated to provide continued coverage to the affected Qualified Beneficiary. If you are continuing coverage under federal law, you must notify the Plan Administrator within 60 days of the birth or adoption of a child. 

Once you have notified the Plan Administrator, you will then be notified by mail of your election rights under COBRA. 

Notification Requirements for Disability Determination 
 If you extend your COBRA coverage beyond 18 months because you are eligible for disability benefits from Social Security, you must provide Human Resources with notice of the Social Security
Administration’s determination within 60 days after you receive that determination, and before the end of your initial 18-month continuation period. 
 The notice requirements will be satisfied by providing written notice to the Plan Administrator at the address stated in Section 15, Important Administrative Information: ERISA. The contents
of the notice must be such that the Plan Administrator is able to determine the covered Employee and qualified beneficiary(ies), the qualifying event or disability, and the date on which the qualifying event occurred. 

Trade Act of 2002 
 The Trade Act
of 2002 amended COBRA to provide for a special second 60-day COBRA election period for certain Participants who have experienced a termination or reduction of hours and who lose group health plan coverage as a result. The special second COBRA
election period is available only to a very limited group of individuals: generally, those who are receiving trade adjustment assistance (TAA) or ‘alternative trade adjustment assistance’ under a federal law called the Trade Act of 1974.
These Participants are entitled to a second opportunity to elect COBRA coverage for themselves and certain family members (if they did not already elect COBRA coverage), but only within a limited period of 60 days from the first day of the month
when an individual begins receiving TAA (or would be eligible to receive TAA but for the requirement that unemployment benefits be exhausted) and only during the six months immediately after their group health plan coverage ended. 

  
  

			
	 86
	  	SECTION 12 - WHEN COVERAGE ENDS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 If a Participant qualifies or may qualify for assistance under the Trade Act of 1974, he or she should
contact the Plan Administrator for additional information. The Participant must contact the Plan Administrator promptly after qualifying for assistance under the Trade Act of 1974 or the Participant will lose his or her special COBRA rights. COBRA
coverage elected during the special second election period is not retroactive to the date that Plan coverage was lost, but begins on the first day of the special second election period. 
 When COBRA Ends 
 COBRA coverage will end before the maximum continuation period shown above
if: 
  

	•	 	 you or your covered Dependent becomes covered under another group medical plan, as long as the other plan doesn’t limit your coverage due to a
preexisting condition; or if the other plan does exclude coverage due to your preexisting condition, your COBRA benefits would end when the exclusion period ends; 

 

	•	 	 you or your covered Dependent becomes entitled to, and enrolls in, Medicare after electing COBRA; 

 

	•	 	 the first required premium is not paid within 45 days; 

 

	•	 	 any other monthly premium is not paid within 30 days of its due date; 

 

	•	 	 the entire Plan ends; or 

  

	•	 	 coverage would otherwise terminate under the Plan as described in the beginning of this section. 

Note: If you selected continuation coverage under a prior plan which was then replaced by coverage under this Plan, continuation coverage
will end as scheduled under the prior plan or in accordance with the terminating events listed in this section, whichever is earlier. 

Uniformed Services Employment and Reemployment Rights Act 
 A Participant who is absent from employment for more than 30 days by reason of service in the Uniformed Services may elect to continue Plan coverage for the Participant and the Participant’s
Dependents in accordance with the Uniformed Services Employment and Reemployment Rights Act of 1994, as amended (USERRA). 
 The terms
“Uniformed Services” or “Military Service” mean the Armed Forces, the Army National Guard and the Air National Guard when engaged in active duty for training, inactive duty training, or full-time National Guard duty, the
commissioned corps of the Public Health Service, and any other category of persons designated by the President in time of war or national emergency. 
 If qualified to continue coverage pursuant to the USERRA, Participants may elect to continue coverage under the Plan by notifying the Plan Administrator in advance, and providing payment of any required
contribution for the health coverage. This may include the amount the Plan Administrator normally pays on a Participant’s behalf. If a Participant’s Military Service is for a period of time less than 31 days, the Participant may not be
required to pay more than the regular contribution amount, if any, for continuation of health coverage. 

  
  

			
	 87
	  	SECTION 12 - WHEN COVERAGE ENDS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 A Participant may continue Plan coverage under USERRA for up to the lesser of: 

 

	•	 	 the 24 month period beginning on the date of the Participant’s absence from work; or 

 

	•	 	 the day after the date on which the Participant fails to apply for, or return to, a position of employment. 

Regardless of whether a Participant continues health coverage, if the Participant returns to a position of employment, the Participant’s health
coverage and that of the Participant’s eligible Dependents will be reinstated under the Plan. No exclusions or waiting period may be imposed on a Participant or the Participant’s eligible Dependents in connection with this reinstatement,
unless a Sickness or Injury is determined by the Secretary of Veterans Affairs to have been incurred in, or aggravated during, the performance of military service. 
 You should call the Plan Administrator if you have questions about your rights to continue health coverage under USERRA. 

  
  

			
	 88
	  	SECTION 12 - WHEN COVERAGE ENDS

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 13 - OTHER IMPORTANT INFORMATION 
 What this section includes: 
  

	•	 	 Court-ordered Benefits for Dependent children; 

  

	•	 	 Your relationship with UnitedHealthcare and Kansas City Life Insurance Company; 

 

	•	 	 Relationships with providers; 

  

	•	 	 Interpretation of Benefits; 

  

	•	 	 Information and records; 

  

	•	 	 Incentives to providers and you; 

  

	•	 	 The future of the Plan; and 

  

	•	 	 How to access the official Plan documents. 

 Qualified Medical Child Support Orders (QMCSOs) 
 A qualified medical child support order
(QMCSO) is a judgment, decree or order issued by a court or appropriate state agency that requires a child to be covered for medical benefits. Generally, a QMCSO is issued as part of a paternity, divorce, or other child support settlement.

 If the Plan receives a medical child support order for your child that instructs the Plan to cover the child, the Plan Administrator will
review it to determine if it meets the requirements for a QMCSO. If it determines that it does, your child will be enrolled in the Plan as your Dependent, and the Plan will be required to pay Benefits as directed by the order. 

You may obtain, without charge, a copy of the procedures governing QMCSOs from the Plan Administrator. 

Note: A National Medical Support Notice will be recognized as a QMCSO if it meets the requirements of a QMCSO. 

Your Relationship with UnitedHealthcare and Kansas City Life Insurance Company 
 In order to make choices about your health care coverage and treatment, Kansas City Life Insurance Company believes that it is important for you to understand how UnitedHealthcare interacts with the Plan
Sponsor’s benefit Plan and how it may affect you. UnitedHealthcare helps administer the Plan Sponsor’s benefit Plan in which you are enrolled. UnitedHealthcare does not provide medical services or make treatment decisions. This means:

  

	•	 	 Kansas City Life Insurance Company and UnitedHealthcare do not decide what care you need or will receive. You and your Physician make those decisions;

  
  

			
	 89
	  	SECTION 13 - OTHER IMPORTANT INFORMATION

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 UnitedHealthcare communicates to you decisions about whether the Plan will cover or pay for the health care that you may receive (the Plan pays for
Covered Health Services, which are more fully described in this SPD); and 

  

	•	 	 the Plan may not pay for all treatments you or your Physician may believe are necessary. If the Plan does not pay, you will be responsible for the
cost. 

 Kansas City Life Insurance Company and UnitedHealthcare may use individually identifiable information about you to
identify for you (and you alone) procedures, products or services that you may find valuable. Kansas City Life Insurance Company and UnitedHealthcare will use individually identifiable information about you as permitted or required by law, including
in our operations and in our research. Kansas City Life Insurance Company and UnitedHealthcare will use de-identified data for commercial purposes including research. 
 Relationship with Providers 
 The relationships between Kansas City Life Insurance Company,
UnitedHealthcare and Network providers are solely contractual relationships between independent contractors. Network providers are not Kansas City Life Insurance Company’s agents or employees, nor are they agents or employees of
UnitedHealthcare. Kansas City Life Insurance Company and any of its employees are not agents or employees of Network providers, nor are UnitedHealthcare and any of its employees agents or employees of Network providers. 

Kansas City Life Insurance Company and UnitedHealthcare do not provide health care services or supplies, nor do they practice medicine. Instead, Kansas
City Life Insurance Company and UnitedHealthcare arranges for health care providers to participate in a Network and pay Benefits. Network providers are independent practitioners who run their own offices and facilities. UnitedHealthcare’s
credentialing process confirms public information about the providers’ licenses and other credentials, but does not assure the quality of the services provided. They are not Kansas City Life Insurance Company’s employees nor are they
employees of UnitedHealthcare. Kansas City Life Insurance Company and UnitedHealthcare do not have any other relationship with Network providers such as principal-agent or joint venture. Kansas City Life Insurance Company and UnitedHealthcare are
not liable for any act or omission of any provider. 
 UnitedHealthcare is not considered to be an employer of the Plan Administrator for any
purpose with respect to the administration or provision of benefits under this Plan. 
 Kansas City Life Insurance Company and the Plan
Administrator are solely responsible for: 
  

	•	 	 enrollment and classification changes (including classification changes resulting in your enrollment or the termination of your coverage);

  

	•	 	 the timely payment of Benefits; and 

  

	•	 	 notifying you of the termination or modifications to the Plan. 

  
  

			
	 90
	  	SECTION 13 - OTHER IMPORTANT INFORMATION

 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Your Relationship with Providers 
 The relationship between you and any provider is that of provider and patient. Your provider is solely responsible for the quality of the services provided to you. You: 

 

	•	 	 are responsible for choosing your own provider; 

  

	•	 	 are responsible for paying, directly to your provider, any amount identified as a member responsibility, including Copayments, Coinsurance, any Annual
Deductible and any amount that exceeds Eligible Expenses; 

  

	•	 	 are responsible for paying, directly to your provider, the cost of any non-Covered Health Service; 

 

	•	 	 must decide if any provider treating you is right for you (this includes Network providers you choose and providers to whom you have been referred);
and 

  

	•	 	 must decide with your provider what care you should receive. 

 Interpretation of Benefits 
 Kansas City Life Insurance Company and UnitedHealthcare have
the sole and exclusive discretion to: 
  

	•	 	 interpret Benefits under the Plan; 

  

	•	 	 interpret the other terms, conditions, limitations and exclusions of the Plan, including this SPD and any Riders and/or Amendments; and

  

	•	 	 make factual determinations related to the Plan and its Benefits. 

 Kansas City Life Insurance Company and UnitedHealthcare may delegate this discretionary authority to other persons or entities that provide services in regard to the administration of the Plan.

 In certain circumstances, for purposes of overall cost savings or efficiency, Kansas City Life Insurance Company may, in its discretion,
offer Benefits for services that would otherwise not be Covered Health Services. The fact that Kansas City Life Insurance Company does so in any particular case shall not in any way be deemed to require Kansas City Life Insurance Company to do so in
other similar cases. 
 Information and Records 
 Kansas City Life Insurance Company and UnitedHealthcare may use your individually identifiable health information to administer the Plan and pay claims, to identify procedures, products, or services that
you may find valuable, and as otherwise permitted or required by law. Kansas City Life Insurance Company and UnitedHealthcare may request additional information from you to decide your claim for Benefits. Kansas City Life Insurance Company and
UnitedHealthcare will keep this information confidential. Kansas City Life Insurance Company and the Claims Administrator may also use your de-identified data for commercial purposes, including research, as permitted by law. 

  
  

			
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 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 By accepting Benefits under the Plan, you authorize and direct any person or institution that has
provided services to you to furnish Kansas City Life Insurance Company and UnitedHealthcare with all information or copies of records relating to the services provided to you. Kansas City Life Insurance Company and UnitedHealthcare have the right to
request this information at any reasonable time. This applies to all Covered Persons, including Enrolled Dependents whether or not they have signed the Participant’s enrollment form. Kansas City Life Insurance Company and UnitedHealthcare agree
that such information and records will be considered confidential. 
 Kansas City Life Insurance Company and UnitedHealthcare have the right to
release any and all records concerning health care services which are necessary to implement and administer the terms of the Plan, for appropriate medical review or quality assessment, or as Kansas City Life Insurance Company is required to do by
law or regulation. During and after the term of the Plan, Kansas City Life Insurance Company and UnitedHealthcare and its related entities may use and transfer the information gathered under the Plan in a de-identified format for commercial
purposes, including research and analytic purposes. 
 For complete listings of your medical records or billing statements Kansas City Life
Insurance Company recommends that you contact your health care provider. Providers may charge you reasonable fees to cover their costs for providing records or completing requested forms. 
 If you request medical forms or records from UnitedHealthcare, they also may charge you reasonable fees to cover costs for completing the forms or providing the records. 

In some cases, Kansas City Life Insurance Company and UnitedHealthcare will designate other persons or entities to request records or information from or
related to you, and to release those records as necessary. Our designees have the same rights to this information as does the Plan Administrator. 
 Incentives to Providers 
 Network providers may be provided financial incentives by
UnitedHealthcare to promote the delivery of health care in a cost efficient and effective manner. These financial incentives are not intended to affect your access to health care. 
 Examples of financial incentives for Network providers are: 
  

	•	 	 bonuses for performance based on factors that may include quality, member satisfaction, and/or cost-effectiveness; or 

 

	•	 	 a practice called capitation which is when a group of Network providers receives a monthly payment from UnitedHealthcare for each Covered Person who
selects a Network provider within the group to perform or coordinate certain health services. The Network providers receive this monthly payment regardless of whether the cost of providing or arranging to provide the Covered Person’s health
care is less than or more than the payment. 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 If you have any questions regarding financial incentives you may contact the telephone number on your ID
card. You can ask whether your Network provider is paid by any financial incentive, including those listed above; however, the specific terms of the contract, including rates of payment, are confidential and cannot be disclosed. In addition, you may
choose to discuss these financial incentives with your Network provider. 
 Incentives to You 

Sometimes you may be offered coupons or other incentives to encourage you to participate in various wellness programs or certain disease management
programs. The decision about whether or not to participate is yours alone but Kansas City Life Insurance Company recommends that you discuss participating in such programs with your Physician. These incentives are not Benefits and do not alter or
affect your Benefits. You may call the number on the back of your ID card if you have any questions. 
 Rebates and Other Payments

 Kansas City Life Insurance Company and UnitedHealthcare may receive rebates for certain drugs that are administered to you in a
Physician’s office, or at a Hospital or Alternate Facility. This includes rebates for those drugs that are administered to you before you meet your Annual Deductible. Kansas City Life Insurance Company and UnitedHealthcare do not pass these
rebates on to you, nor are they applied to your Annual Deductible or taken into account in determining your Copays or Coinsurance. 

Workers’ Compensation Not Affected 

Benefits provided under the Plan do not substitute for and do not affect any requirements for coverage by workers’ compensation insurance.

 Future of the Plan 
 Although
the Company expects to continue the Plan indefinitely, it reserves the right to discontinue, alter or modify the Plan in whole or in part, at any time and for any reason, at its sole determination. 

The Company’s decision to terminate or amend a Plan may be due to changes in federal or state laws governing employee benefits, the requirements of
the Internal Revenue Code or Employee Retirement Income Security Act of 1974 (ERISA), or any other reason. A plan change may transfer plan assets and debts to another plan or split a plan into two or more parts. If the Company does change or
terminate a plan, it may decide to set up a different plan providing similar or different benefits. 
 If this Plan is terminated, Covered
Persons will not have the right to any other Benefits from the Plan, other than for those claims incurred prior to the date of termination, or as otherwise provided under the Plan. In addition, if the Plan is amended, Covered Persons may be subject
to altered coverage and Benefits. 
 The amount and form of any final benefit you receive will depend on any Plan document or contract
provisions affecting the Plan and Company decisions. After all Benefits have been paid and other requirements of the law have been met, certain remaining Plan assets will be turned over to the Company and others as may be required by any applicable
law. 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Plan Document 
 This Summary Plan Description (SPD) represents an overview of your Benefits. In the event there is a discrepancy between the SPD and the official plan document, the plan document will govern. Copies of
these documents, as well as the latest summary annual reports of Plan operations and Plan descriptions as filed with the Internal Revenue Service and the U.S. Department of Labor, are available for your inspection during regular business hours in
the office of the Plan Administrator. You (or your personal representative) may obtain a copy of these documents by written request to the Plan Administrator, for a nominal charge. 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 SECTION 14 - GLOSSARY 
 What this section includes: 
  

	•	 	 Definitions of terms used throughout this SPD. 

 Many of the terms used throughout this SPD may be unfamiliar to you or have a specific meaning with regard to the way the Plan is administered and how Benefits are paid. This section defines terms used
throughout this SPD, but it does not describe the Benefits provided by the Plan. 
 Addendum – any attached written description of
additional or revised provisions to the Plan. The benefits and exclusions of this SPD and any amendments thereto shall apply to the Addendum except that in the case of any conflict between the Addendum and SPD and/or Amendments to the SPD, the
Addendum shall be controlling. 
 Alternate Facility – a health care facility that is not a Hospital and that provides one or more
of the following services on an outpatient basis, as permitted by law: 
  

	•	 	 surgical services; 

  

	•	 	 Emergency Health Services; or 

  

	•	 	 rehabilitative, laboratory, diagnostic or therapeutic services. 

 An Alternate Facility may also provide Mental Health or Substance Abuse Services on an outpatient basis or inpatient basis. 
 Amendment – any attached written description of additional or alternative provisions to the Plan. Amendments are effective only when distributed by the Plan Sponsor or the Plan Administrator.
Amendments are subject to all conditions, limitations and exclusions of the Plan, except for those that the amendment is specifically changing. 

Annual Deductible (or Deductible) – the amount you must pay for Covered Health Services in a calendar year before the Plan will begin paying
Benefits in that calendar year. The Deductible is shown in the first table in Section 5, Plan Highlights. 
 Benefits –
Plan payments for Covered Health Services, subject to the terms and conditions of the Plan and any Addendums and/or Amendments. 
 Body Mass
Index (BMI) – a calculation used in obesity risk assessment which uses a person’s weight and height to approximate body fat. 

BMI – see Body Mass Index (BMI). 

Cancer Resource Services (CRS) – a program administered by UnitedHealthcare or its affiliates made available to you by Kansas City Life
Insurance Company. The CRS program provides: 
  

	•	 	 specialized consulting services to Participants and enrolled Dependents with cancer; 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 access to cancer centers with expertise in treating specific forms of cancer – even the most rare and complex conditions; and

  

	•	 	 guidance for the patient on the prescribed plan of care and the potential side effects of radiation and chemotherapy. 

CHD – see Congenital Heart Disease (CHD). 
 Chiropractic Treatment – the therapeutic application of chiropractic manipulative treatment with or without ancillary physiologic treatment and/or rehabilitative methods rendered to
restore/improve motion, reduce pain and improve function in the management of an identifiable neuromusculoskeletal condition. 
 Claims
Administrator – UnitedHealthcare (also known as United HealthCare Insurance Company) and its affiliates, who provide certain claim administration services for the Plan. 
 Clinical Trial – a scientific study designed to identify new health services that improve health outcomes. In a Clinical Trial, two or more treatments are compared to each other and the
patient is not allowed to choose which treatment will be received. 
 COBRA – see Consolidated Omnibus Budget Reconciliation Act of
1985 (COBRA). 
 Coinsurance – the percentage of Eligible Expenses you are required to pay for certain Covered Health Services as
described in Section 3, How the Plan Works. 
 Company – Kansas City Life Insurance Company. 

Congenital Anomaly – a physical developmental defect that is present at birth and is identified within the first twelve months of birth.

 Congenital Heart Disease (CHD) – any structural heart problem or abnormality that has been present since birth. Congenital heart
defects may: 
  

	•	 	 be passed from a parent to a child (inherited); 

  

	•	 	 develop in the fetus of a woman who has an infection or is exposed to radiation or other toxic substances during her Pregnancy; or

  

	•	 	 have no known cause. 

Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) – a federal law that requires employers to offer continued health insurance
coverage to certain employees and their dependents whose group health insurance has been terminated. 
 Continuous Creditable Coverage
– health care coverage under any of the types of plans listed below, during which there was no break in coverage of 63 consecutive days or more: 
  

	•	 	 a group health plan; 

  

	•	 	 health insurance coverage; 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 Medicare; 

  

	•	 	 Medicaid; 

  

	•	 	 medical and dental care for members and certain former members of the uniformed services, and for their dependents; 

 

	•	 	 a medical care program of the Indian Health Services Program or a tribal organization; 

 

	•	 	 a state health benefits risk pool; 

  

	•	 	 The Federal Employees Health Benefits Program; 

  

	•	 	 The State Children’s Health Insurance Program (S-CHIP); 

 

	•	 	 health plans established and maintained by foreign governments or political subdivisions and by the U.S. government; 

 

	•	 	 any public health benefit program provided by a state, county, or other political subdivision of a state; or 

 

	•	 	 a health benefit plan under the Peace Corps Act. 

 If you or your eligible Dependents were covered by any of the above plans before first becoming covered by this Plan, you should have received a Certificate of Creditable Coverage when that plan’s
coverage ended. 
 Copayment (or Copay) – the set dollar amount you are required to pay for certain Covered Health Services as
described in Section 3, How the Plan Works. 
 Cosmetic Procedures – procedures or services that change or improve
appearance without significantly improving physiological function, as determined by the Claims Administrator. Reshaping a nose with a prominent bump is a good example of a Cosmetic Procedure because appearance would be improved, but there would be
no improvement in function like breathing. 
 Cost-Effective – the least expensive equipment that performs the necessary function.
This term applies to Durable Medical Equipment and prosthetic devices. 
 Covered Health Services – those health services, including
services, supplies or Pharmaceutical Products, which Kansas City Life Insurance Company determines to be: 
  

	•	 	 provided for the purpose of preventing, diagnosing or treating Sickness, Injury, Mental Illness, substance abuse, or their symptoms;

  

	•	 	 consistent with nationally recognized scientific evidence as available, and prevailing medical standards and clinical guidelines as described below;

  

	•	 	 not provided for the convenience of the Covered Person, Physician, facility or any other person; 

 

	•	 	 included in Sections 5 and 6, Plan Highlights and Additional Coverage Details; 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 provided to a Covered Person who meets the Plan’s eligibility requirements, as described under Eligibility in Section 2,
Introduction; and 

  

	•	 	 not identified in Section 8, Exclusions. 

 In applying the above definition, “scientific evidence” and “prevailing medical standards” have the following meanings: 

 

	•	 	 “scientific evidence” means the results of controlled Clinical Trials or other studies published in peer-reviewed, medical literature
generally recognized by the relevant medical specialty community; and 

  

	•	 	 “prevailing medical standards and clinical guidelines” means nationally recognized professional standards of care including, but not limited
to, national consensus statements, nationally recognized clinical guidelines, and national specialty society guidelines. 

The Claims Administrator maintains clinical protocols that describe the scientific evidence, prevailing medical standards and clinical guidelines
supporting its determinations regarding specific services. You can access these clinical protocols (as revised from time to time) on www.myuhc.com or by calling the number on the back of your ID card. This information is available to
Physicians and other health care professionals on UnitedHealthcareOnline. 
 Covered Person – either the Participant or an enrolled
Dependent only while enrolled and eligible for Benefits under the Plan. References to “you” and “your” throughout this SPD are references to a Covered Person. 
 CRS – see Cancer Resource Services (CRS). 
 Custodial Care – services that
do not require special skills or training and that: 
  

	•	 	 provide assistance in activities of daily living (including but not limited to feeding, dressing, bathing, ostomy care, incontinence care, checking of
routine vital signs, transferring and ambulating); 

  

	•	 	 do not seek to cure, or which are provided during periods when the medical condition of the patient who requires the service is not changing; or

  

	•	 	 do not require continued administration by trained medical personnel in order to be delivered safely and effectively. 

Deductible – see Annual Deductible. 

Dependent – an individual who meets the eligibility requirements specified in the Plan, as described under Eligibility in
Section 2, Introduction. A Dependent does not include anyone who is also enrolled as a Participant. No one can be a Dependent of more than one Participant. 
 Designated Facility – a facility that has entered into an agreement with the Claims Administrator or with an organization contracting on behalf of the Plan, to provide Covered Health Services
for the treatment of specified diseases or conditions. A Designated Facility may or may not be located within your geographic area. 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 To be considered a Designated Facility, a facility must meet certain standards of excellence and have a
proven track record of treating specific conditions. 
 DME – see Durable Medical Equipment (DME). 

Domiciliary Care – living arrangements designed to meet the needs of people who cannot live independently but do not require Skilled Nursing
Facility services. 
 Durable Medical Equipment (DME) – medical equipment that is all of the following: 

 

	•	 	 used to serve a medical purpose with respect to treatment of a Sickness, Injury or their symptoms; 

 

	•	 	 not disposable; 

  

	•	 	 not of use to a person in the absence of a Sickness, Injury or their symptoms; 

 

	•	 	 durable enough to withstand repeated use; 

  

	•	 	 not implantable within the body; and 

  

	•	 	 appropriate for use, and primarily used, within the home. 

 Eligible Expenses – charges for Covered Health Services that are provided while the Plan is in effect, determined as follows: 

 

							
	  

For:
  
	  	  
 Eligible Expenses are Based On:
  

	  

Network Benefits
	  	  
 Contracted rates with the provider
  

	  

Non-Network Benefits
	  	  
 •
	  	  
 negotiated rates agreed to by the non-Network provider and either the Claims Administrator or one of its vendors, affiliates or subcontractors.

 

	 	  	  
 •
	  	  

one of the following:
  

	 	  		  	  
 •
	  	  
 for
Covered Health Services other than Pharmaceutical Products, selected data resources which, in the judgment of the Claims Administrator, represent competitive fees in that geographic area;

	 	  		  	 •
	  	 for Covered Health Services that are Pharmaceutical Products, 100% of the
amount that the Centers for Medicare and Medicaid Services (CMS) would have paid under the Medicare program for the drug determined by either:

	 	  		  	 •
	  	 reference to available CMS schedules; or

	 	  		  	 •
	  	 methods similar to those used by
CMS;

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

							
	  

For:
  
	  	  
 Eligible Expenses are Based On:
  

	 	  	 	  	  
 •
	  	  
 fee(s) that are negotiated with the provider;
  

	 	  	  
 •

 
	  	  

60% of the billed charge; or

	 	  	  
 •
	  	  

A fee schedule that the Claims Administrator develops.

	 	  	  
 These provisions do not apply if you receive Covered Health Services from a non-Network provider in an Emergency. In that case, Eligible Expenses are the amounts billed by the provider, unless the Claims
Administrator negotiates lower rates.

 For certain Covered Health Services, you are required to pay a percentage of Eligible
Expenses in the form of a Copay and/or Coinsurance. 
 Eligible Expenses are subject to the Claims Administrator’s reimbursement policy
guidelines. You may request a copy of the guidelines related to your claim from the Claims Administrator. 
 Emergency – a serious
medical condition or symptom resulting from Injury, Sickness or Mental Illness, or substance abuse which: 
  

	•	 	 arises suddenly; and 

  

	•	 	 in the judgment of a reasonable person, requires immediate care and treatment, generally received within 24 hours of onset, to avoid jeopardy to life
or health. 

 Emergency Health Services – health care services and supplies necessary for the treatment of an
Emergency. 
 Employee Retirement Income Security Act of 1974 (ERISA) – the federal legislation that regulates retirement and
employee welfare benefit programs maintained by employers and unions. 
 Employer – Kansas City Life Insurance Company. 

EOB – see Explanation of Benefits (EOB). 
 ERISA – see Employee Retirement Income Security Act of 1974 (ERISA). 
 Experimental
or Investigational Services – medical, surgical, diagnostic, psychiatric, substance abuse or other health care services, technologies, supplies, treatments, procedures, drug therapies, medications or devices that, at the time
UnitedHealthcare and Kansas City Life Insurance Company make a determination regarding coverage in a particular case, are determined to be any of the following: 
  

	•	 	 not approved by the U.S. Food and Drug Administration (FDA) to be lawfully marketed for the proposed use and not identified in the American Hospital
Formulary Service or the United States Pharmacopoeia Dispensing Information as appropriate for the proposed use; 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 subject to review and approval by any institutional review board for the proposed use (Devices which are FDA approved under the Humanitarian Use
Device exemption are not considered to be Experimental or Investigational); or 

  

	•	 	 the subject of an ongoing Clinical Trial that meets the definition of a Phase 1, 2 or 3 Clinical Trial set forth in the FDA regulations, regardless of
whether the trial is actually subject to FDA oversight. 

 Exceptions: 

 

	•	 	 If you have a life threatening Sickness or condition (one that is likely to cause death within one year of the request for treatment), UnitedHealthcare
and Kansas City Life Insurance Company may, at their discretion, consider an otherwise Experimental or Investigational Service to be a Covered Health Service for that Sickness or condition. Prior to such consideration, UnitedHealthcare and Kansas
City Life Insurance Company must determine that, although unproven, the service has significant potential as an effective treatment for that Sickness or condition, and that the service would be provided under standards equivalent to those defined by
the National Institutes of Health. 

 Explanation of Benefits (EOB) – a statement provided by UnitedHealthcare to
you, your Physician, or another health care professional that explains: 
  

	•	 	 the Benefits provided (if any); 

  

	•	 	 the allowable reimbursement amounts; 

  

	•	 	 Deductibles; 

  

	•	 	 Coinsurance; 

  

	•	 	 any other reductions taken; 

  

	•	 	 the net amount paid by the Plan; and 

  

	•	 	 the reason(s) why the service or supply was not covered by the Plan. 

 Full-time Student – a person who is enrolled in and attending, full-time, a recognized course of study or training at: 

 

	•	 	 an accredited high school; 

  

	•	 	 an accredited college or university; or 

  

	•	 	 a licensed vocational, technical, automotive, or beautician school, or similar training school. 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 The educational institution determines what constitutes Full-time Student status. You are no longer a
Full-time Student as of the last day of the calendar month you graduate or otherwise cease to be enrolled and in attendance at the institution on a full-time basis. 
 You continue to be a Full-time Student during periods of regular vacation established by the institution. If you do not continue as a Full-time Student immediately following the period of vacation, the
Full-time Student designation will end as described above. 
 Health Statement(s) – a single, integrated statement that summarizes
EOB information by providing detailed content on account balances and claim activity. 
 Home Health Agency – a program or
organization authorized by law to provide health care services in the home. 
 Hospital – an institution, operated as required by
law, which is: 
  

	•	 	 primarily engaged in providing health services, on an inpatient basis, for the acute care and treatment of sick or injured individuals. Care is
provided through medical, mental health, substance abuse, diagnostic and surgical facilities, by or under the supervision of a staff of Physicians; and 

 

	•	 	 has 24 hour nursing services. 

 A Hospital is not primarily a place for rest, Custodial Care or care of the aged and is not a Skilled Nursing Facility, convalescent home or similar institution. 

Injury – bodily damage other than Sickness, including all related conditions and recurrent symptoms. 

Inpatient Rehabilitation Facility – a Hospital (or a special unit of a Hospital that is designated as an Inpatient Rehabilitation Facility)
that provides physical therapy, occupational therapy and/or speech therapy on an inpatient basis, as authorized by law. 
 Inpatient Stay
– an uninterrupted confinement, following formal admission to a Hospital, Skilled Nursing Facility or Inpatient Rehabilitation Facility. 

Intermediate Care – Mental Health/Substance Abuse treatment that encompasses the following: 

 

	 	•	 	 is established and operated in accordance with any applicable state law; 

 

	 	•	 	 provides a program of treatment approved by a Physician and the Mental Health/Substance Abuse Administrator; 

 

	 	•	 	 has or maintains a written, specific and detailed regimen requiring full-time residence and full-time participation by the patient;

  

	 	•	 	 provides at least the following basic services: 

  

	 	•	 	 room and board; 

  

	 	•	 	 evaluation and diagnosis; 

  

	 	•	 	 counseling; and 

  

	 	•	 	 referral and orientation to specialized community resources;] 

  
  

			
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COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

  

	•	 	 care at a partial Hospital/day treatment program, which is a freestanding or Hospital-based program that provides services for at least 20 hours per
week; and 

  

	•	 	 care through an intensive outpatient program, which is a freestanding or Hospital-based program that provides services for at least nine hours per
week. This encompasses half-day (i.e. less than four hours per day) partial Hospital programs. 

 Intermittent Care
– skilled nursing care that is provided or needed either: 
  

	•	 	 fewer than seven days each week; or 

  

	•	 	 fewer than eight hours each day for periods of 21 days or less. 

 Exceptions may be made in special circumstances when the need for additional care is finite and predictable. 
 Kidney Resource Services (KRS) – a program administered by UnitedHealthcare or its affiliates made available to you by Kansas City Life Insurance Company. The KRS program provides: 

 

	•	 	 specialized consulting services to Participants and enrolled Dependents with ESRD or chronic kidney disease; 

 

	•	 	 access to dialysis centers with expertise in treating kidney disease; and 

 

	•	 	 guidance for the patient on the prescribed plan of care. 

 Late Enrollee – a Participant or Dependent who enrolls for coverage under the Plan at a time other than: 
  

	•	 	 within 31 days of the date you first become eligible for coverage under the Plan; 

 

	•	 	 during an Open Enrollment; or 

  

	•	 	 within 31 days of the date you experience a change in family status as described under Changing Your Coverage in Section 2,
Introduction. 

 Lifetime Maximum Benefit – the most the Plan will pay for Benefits during the entire
period you are enrolled in this Plan or any other medical plan offered by Kansas City Life Insurance Company. The Lifetime Maximum Benefit is shown in the first table in Section 5, Plan Highlights. 

Medicaid – a federal program administered and operated individually by participating state and territorial governments that provides medical
benefits to eligible low-income people needing health care. The federal and state governments share the program’s costs. 
 Medicare
– Parts A, B, C and D of the insurance program established by Title XVIII, United States Social Security Act, as amended by 42 U.S.C. Sections 1394, et seq. and as later amended. 
 Mental Health Services – Covered Health Services for the diagnosis and treatment of Mental Illnesses. The fact that a condition is listed in the current Diagnostic and Statistical Manual of
Mental Disorders does not mean that treatment for the condition is a Covered Health Service. 

  
  

			
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 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Mental Health/Substance Abuse (MH/SA) Administrator – the organization or individual
designated by Kansas City Life Insurance Company who provides or arranges Mental Health and Substance Abuse Services under the Plan. 

Mental Illness – mental health or psychiatric diagnostic categories listed in the American Psychiatric Association’s Diagnostic and
Statistical Manual of Mental Disorders, unless they are listed in Section 8, Exclusions. 
 Network
– when used to describe a provider of health care services, this means a provider that has a participation agreement in effect (either directly or indirectly) with the Claims Administrator or with its affiliate to participate in the Network;
however, this does not include those providers who have agreed to discount their charges for Covered Health Services by way of their participation in the Shared Savings Program. The Claims Administrator’s affiliates are those entities
affiliated with the Claims Administrator through common ownership or control with the Claims Administrator or with the Claims Administrator’s ultimate corporate parent, including direct and indirect subsidiaries. 

A provider may enter into an agreement to provide only certain Covered Health Services, but not all Covered Health Services, or to be a Network provider
for only some products. In this case, the provider will be a Network provider for the Covered Health Services and products included in the participation agreement, and a non-Network provider for other Covered Health Services and products. The
participation status of providers will change from time to time. 
 Network Benefits – description of how Benefits are paid for
Covered Health Services provided by Network provider. Refer to Section 5, Plan Highlights for details about how Network Benefits apply. 
 Non-Network Benefits – description of how Benefits are paid for Covered Health Services provided by non-Network providers. Refer to Section 5, Plan Highlights for details about how
Non-Network Benefits apply. 
 Open Enrollment – the period of time, determined by Kansas City Life Insurance Company, during which
eligible Participants may enroll themselves and their Dependents under the Plan. Kansas City Life Insurance Company determines the period of time that is the Open Enrollment period. 
 Out-of-Pocket Maximum – the maximum amount you pay every calendar year. Refer to Section 5, Plan Highlights for the Out-of-Pocket Maximum amount. See Section 3, How the
Plan Works for a description of how the Out-of-Pocket Maximum works. 
 Participant – a full-time Participant of the Employer
who meets the eligibility requirements specified in the Plan, as described under Eligibility in Section 2, Introduction. A Participant must live and/or work in the United States. 

  
  

			
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 KANSAS CITY LIFE INSURANCE
COMPANY MEDICAL CHOICE PLUS TRADITIONAL PLAN 

 
  

 Personal Health Support – programs provided by the Claims Administrator that focus on
prevention, education, and closing the gaps in care designed to encourage an efficient system of care for you and your covered Dependents. 

Personal Health Support Nurse – the primary nurse that UnitedHealthcare may assign to you if you have a chronic or complex health condition.
If a Personal Health Support Nurse is assigned to you, this nurse will call you to assess your progress and provide you with information and education. 
 Pharmaceutical Products – FDA-approved prescription pharmaceutical products administered in connection with a Covered Health Service by a Physician or other health care provider within the
scope of the provider’s license, and not otherwise excluded under the Plan. 
 Physician – any Doctor of Medicine or Doctor of
Osteopathy who is properly licensed and qualified by law. 
 Please note: Any podiatrist, dentist, psychologist, chiropractor, optometrist or
other provider who acts within the scope of his or her license will be considered on the same basis as a Physician. The fact that a provider is described as a Physician does not mean that Benefits for services from that provider are available to you
under the Plan. 
 Plan – The Kansas City Life Employee Medical Plan. 
 Plan Administrator – Kansas City Life Insurance Company or its designee. 
 Plan
Sponsor – Kansas City Life Insurance Company. 
 Preexisting Condition – any Sickness or that is identified by the Plan
Administrator as having been diagnosed or treated, or for which prescriptions drugs were prescribed or taken within the six months before coverage under this Plan begins (or the first day of any waiting period, if earlier). A Preexisting Condition
does not include Pregnancy. Genetic information is not an indicator of a Preexisting Condition, if there is not a diagnosis of a condition related to the genetic information. 
 If you have Continuous Creditable Coverage, you or your Dependent will be eligible to receive Plan Benefits for a Preexisting Condition. Continuous Creditable Coverage is defined in this section.

 Pregnancy – includes prenatal care, postnatal care, childbirth, and any complications associated with Pregnancy. 

Primary Physician – a Physician who has a majority of his or her practice in general pediatrics, internal medicine, obstetrics/gynecology,
family practice or general medicine. 
 Reconstructive Procedure – a procedure performed to address a physical impairment where the
expected outcome is restored or improved function. The primary purpose of a Reconstructive Procedure is either to treat a medical condition or to improve or restore physiologic function. Reconstructive Procedures include surgery or other procedures
which 

  
  

			
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are associated with an Injury, Sickness or Congenital Anomaly. The primary result of the procedure is not changed or improved physical appearance. The fact that a person may suffer
psychologically as a result of the impairment does not classify surgery or any other procedure done to relieve the impairment as a Reconstructive Procedure. 
 Retired Employee – an Employee who retires while covered under the Plan. 

Semi-private Room – a room with two or more beds. When an Inpatient Stay in a Semi-private Room is a Covered Health Service, the difference
in cost between a Semi-private Room and a private room is a benefit only when a private room is necessary in terms of generally accepted medical practice, or when a Semi-private Room is not available. 

Shared Savings Program – the Shared Savings Program provides access to discounts from non-Network Physicians who participate in that program.
UnitedHealthcare will use the Shared Savings Program to pay claims when doing so will lower Eligible Expenses. While UnitedHealthcare might negotiate lower Eligible Expenses for Non-Network Benefits, the Coinsurance will stay the same as described
in Section 5, Plan Highlights. 
 UnitedHealthcare does not credential the Shared Savings Program providers and the Shared Savings
Program providers are not Network providers. Accordingly, in benefit plans that have both Network and non-Network levels of Benefits, Benefits for Covered Health Services provided by Shared Savings Program providers will be paid at the non-Network
Benefit level (except in situations when Benefits for Covered Health Services provided by non-Network providers are payable at Network Benefit levels, as in the case of Emergency Health Services). When UnitedHealthcare uses the Shared Savings
Program to pay a claim, the patient responsibility is limited to Coinsurance calculated on the contracted rate paid to the provider, in addition to any required Annual Deductible. 
 Sickness – physical illness, disease or Pregnancy. The term Sickness as used in this SPD does not include Mental Illness or substance abuse, regardless of the cause or origin of the Mental
Illness or substance abuse. 
 Skilled Care – skilled nursing, teaching, and rehabilitation services when: 

 

	•	 	 they are delivered or supervised by licensed technical or professional medical personnel in order to obtain the specified medical outcome and provide
for the safety of the patient; 

  

	•	 	 a Physician orders them; 

  

	•	 	 they are not delivered for the purpose of assisting with activities of daily living, including, but not limited to, dressing, feeding, bathing or
transferring from a bed to a chair; 

  

	•	 	 they require clinical training in order to be delivered safely and effectively; and 

 

	•	 	 they are not Custodial Care, as defined in this section. 

 Skilled Nursing Facility – a nursing facility that is licensed and operated as required by law. A Skilled Nursing Facility that is part of a Hospital is considered a Skilled Nursing Facility
for purposes of the Plan. 

  
  

			
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 Specialist Physician – a Physician who has a majority of his or her practice in areas other
than general pediatrics, internal medicine, obstetrics/gynecology, family practice or general medicine. 
 Spouse – an individual to
whom you are legally married. 
 Substance Abuse Services – Covered Health Services for the diagnosis and treatment of alcoholism
and substance abuse disorders that are listed in the current Diagnostic and Statistical Manual of Mental Disorders, unless those services are specifically excluded. 
 Total Disability – a Participant’s inability to perform all substantial job duties because of physical or mental impairment, or a Dependent’s or retired person’s inability to
perform the normal activities of a person of like age and gender. 
 Transitional Care – Mental Health/Substance Abuse Services that
are provided through transitional living facilities, group homes and supervised apartments that provide 24-hour supervision that are either: 
  

	•	 	 sober living arrangements such as drug-free housing, alcohol/drug halfway houses. These are transitional, supervised living arrangements that provide
stable and safe housing, an alcohol/drug-free environment and support for recovery. A sober living arrangement may be utilized as an adjunct to ambulatory treatment when treatment doesn’t offer the intensity and structure needed to assist the
Covered Person with recovery. 

  

	•	 	 supervised living arrangement which are residences such as transitional living facilities, group homes and supervised apartments that provide members
with stable and safe housing and the opportunity to learn how to manage their activities of daily living. Supervised living arrangements may be utilized as an adjunct to ambulatory treatment when treatment doesn’t offer the intensity and
structure needed to assist the Covered Person with recovery. 

 UnitedHealth Premium Program – a program that
identifies network Physicians or facilities that have been designated as a UnitedHealth Premium Program Physician or facility for certain medical conditions. 
 To be designated as a UnitedHealth Premium provider, Physicians and facilities must meet program criteria. The fact that a Physician or facility is a Network Physician or facility does not mean that it is
a UnitedHealth Premium Program Physician or facility. 
 Unproven Services – health services, including medications that are
determined not to be effective for treatment of the medical condition and/or not to have a beneficial effect on health outcomes due to insufficient and inadequate clinical evidence from well-conducted randomized controlled trials or cohort studies
in the prevailing published peer-reviewed medical literature: 
  

	•	 	 Well-conducted randomized controlled trials are two or more treatments compared to each other, with the patient not being allowed to choose which
treatment is received. 

  
  

			
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	•	 	 Well-conducted cohort studies are studies in which patients who receive study treatment are compared to a group of patients who receive standard
therapy. The comparison group must be nearly identical to the study treatment group. 

 UnitedHealthcare has a process by
which it compiles and reviews clinical evidence with respect to certain health services. From time to time, UnitedHealthcare issues medical and drug policies that describe the clinical evidence available with respect to specific health care
services. These medical and drug policies are subject to change without prior notice. You can view these policies at www.myuhc.com. 

Please note: 
  

	•	 	 If you have a life threatening Sickness or condition (one that is likely to cause death within one year of the request for treatment), UnitedHealthcare
and Kansas City Life Insurance Company may, at their discretion, consider an otherwise Unproven Service to be a Covered Health Service for that Sickness or condition. Prior to such a consideration, UnitedHealthcare and Kansas City Life Insurance
Company must first establish that there is sufficient evidence to conclude that, albeit unproven, the service has significant potential as an effective treatment for that Sickness or condition, and that the service would be provided under standards
equivalent to those defined by the National Institutes of Health. 

  

	•	 	 UnitedHealthcare and Kansas City Life Insurance Company may, in their discretion, consider an otherwise Unproven Service to be a Covered Health Service
for a Covered Person with a Sickness or Injury that is not life-threatening. For that to occur, all of the following conditions must be met: 

  

	 	•	 	 If the service is one that requires review by the U.S. Food and Drug Administration (FDA), it must be FDA-approved.

  

	 	•	 	 It must be performed by a Physician and in a facility with demonstrated experience and expertise. 

 

	 	•	 	 The Covered Person must consent to the procedure acknowledging that UnitedHealthcare and Kansas City Life Insurance Company do not believe that
sufficient clinical evidence has been published in peer-reviewed medical literature to conclude that the service is safe and/or effective. 

  

	 	•	 	 At least two studies must be available in published peer-reviewed medical literature that would allow UnitedHealthcare and Kansas City Life Insurance
Company to conclude that the service is promising but unproven. 

  

	 	•	 	 The service must be available from a Network Physician and/or a Network facility. 

The decision about whether such a service can be deemed a Covered Health Service is solely at UnitedHealthcare and Kansas City Life Insurance
Company’s discretion. Other apparently similar promising but unproven services may not qualify. 
 Urgent Care – treatment of
an unexpected Sickness or Injury that is not life-threatening but requires outpatient medical care that cannot be postponed. An urgent situation requires prompt medical attention to avoid complications and unnecessary suffering, such as high fever,
a skin rash, or an ear infection. 

  
  

			
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 Urgent Care Center – a facility that provides Urgent Care services, as previously defined in
this section. In general, Urgent Care Centers: 
  

	•	 	 do not require an appointment; 

  

	•	 	 are open outside of normal business hours, so you can get medical attention for minor illnesses that occur at night or on weekends; and

  

	•	 	 provide an alternative if you need immediate medical attention, but your Physician cannot see you right away. 

  
  

			
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 SECTION 15 - IMPORTANT ADMINISTRATIVE INFORMATION: ERISA 

What this section includes: 
  

	•	 	 Plan administrative information, including your rights under ERISA. 

 This section includes information on the administration of the medical Plan, as well as information required of all Summary Plan Descriptions by ERISA as defined in Section 14, Glossary. While
you may not need this information for your day-to-day participation, it is information you may find important. 
 Plan Sponsor and
Administrator 
 Kansas City Life Insurance Company is the Plan Sponsor and Plan Administrator of the Kansas City Life Employee Medical
Plan and has the discretionary authority to interpret the Plan. You may contact the Plan Administrator at: 
 Plan Administrator – Medical
Plan 
 Kansas City Life Insurance Company 
 Human Resources 
 3520 Broadway 
 Kansas City, MO 64111 
 (816) 753-7299, extension 8226 

Claims Administrator 

UnitedHealthcare is the Plan’s Claims Administrator. The role of the Claims Administrator is to handle the day-to-day administration of the
Plan’s coverage as directed by the Plan Administrator, through an administrative agreement with the Company. The Claims Administrator shall not be deemed or construed as an employer for any purpose with respect to the administration or
provision of Benefits under the Plan Sponsor’s Plan. The Claims Administrator shall not be responsible for fulfilling any duties or obligations of an employer with respect to the Plan Sponsor’s Plan. 

You may contact the Claims Administrator by phone at the number on your ID card or in writing at: 

United HealthCare Insurance Company 
 450
Columbus Boulevard 
 Hartford, CT 06115-0450 
 Agent for Service of Legal Process 
 Should it ever be necessary, you or your
personal representative may serve legal process on the agent of service for legal process for the Plan. The Plan’s Agent of Service is: 

General Counsel 
 Kansas City Life Insurance
Company 
 3520 Broadway 
 Kansas City,
MO 64111 
 (816) 753-7000 

  
  

			
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 Legal process may also be served on the Plan Administrator. 

Other Administrative Information 

This section of your SPD contains information about how the Plan is administered as required by ERISA. 

Type of Administration 
 The Plan
is a self-funded welfare Plan and the administration is provided through one or more third party administrators. 
  

			
	  

Plan Name:
  
	  	  

Kansas City Life Employee Medical Plan
  

	  
 Plan Number:
  
	  	  
 503
  

	  
 Employer ID:
  
	  	  
 44-0308260
  

	  
 Plan Type:
  
	  	  
 Welfare benefits plan
  

	  
 Calendar year:
  
	  	  
 January 1 – December 31
  

	  
 Plan Administration:
  
	  	  
 Self-Insured
  

	  
 Source of Plan Contributions:
  
	  	  
 Employee and Company
  

	  
 Source of Benefits:
  
	  	  
 Assets of the Company
  

 Your ERISA Rights 
 As a participant in the Plan, you are entitled to certain rights
and protections under ERISA. ERISA provides that all Plan participants shall be permitted to: 
  

	•	 	 receive information about Plan Benefits; 

  

	•	 	 examine, without charge, at the Plan Administrator’s office and at other specified worksites, all plan documents – including pertinent
insurance contracts, trust agreements, collective bargaining agreements, summary annual reports, and other documents filed with the Internal Revenue Service or the U.S. Department of Labor, and available at the Public Disclosure Room of the Employee
Benefits Security Administration; 

  

	•	 	 obtain copies of all Plan documents and other Plan information, including insurance contracts and collective bargaining agreements, and copies of the
latest summary annual reports, and updated Summary Plan Descriptions, by writing to the Plan Administrator. The Plan Administrator may make a reasonable charge for copies; and 

 

	•	 	 receive a summary annual report of the Plan’s financial activities. The Plan Administrator is required by law to furnish each participant with a
copy of this summary annual report. 

  
  

			
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 You can continue health care coverage for yourself, Spouse or Dependents if there is a loss of coverage
under the Plan as a result of a qualifying event. You or your Dependents may have to pay for such coverage. Review this Summary Plan Description and the Plan documents to understand the rules governing your COBRA continuation coverage rights.

 You will be provided a certificate of creditable coverage in writing, free of charge, from UnitedHealthcare: 

 

	•	 	 when you lose coverage under the Plan; 

  

	•	 	 when you become entitled to elect COBRA; 

  

	•	 	 when your COBRA coverage ends; 

  

	•	 	 if you request a certificate of credible coverage before losing coverage; or 

 

	•	 	 if you request a certificate of credible coverage up to 24 months after losing coverage. 

You may request a certificate of creditable coverage by calling the toll-free number on your ID card. 

If you have creditable coverage from another group health plan, you may receive a reduction or elimination of exclusionary periods of coverage for
preexisting conditions under your group health plan. Without evidence of creditable coverage, Plan Benefits for the treatment of a preexisting condition may be excluded for 12 months (18 months for late enrollees) after your enrollment date in your
coverage. In addition to creating rights for Plan participants, ERISA imposes duties on the people who are responsible for the operation of the Plan. The people who operate your Plan, who are called “fiduciaries” of the Plan, have a duty
to do so prudently and in the interest of you and other Plan participants and beneficiaries. No one, including your Employer or any other person may fire you or otherwise discriminate against you in any way to prevent you from obtaining a Plan
Benefit or exercising your rights under ERISA. 
 If your claim for a Plan Benefit is denied or ignored, in whole or in part, you have a right
to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules. See Section 9, Claims Procedures, for details. 

Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of plan documents or the latest summary annual
report from the Plan, and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $110 a day until you receive the materials,
unless the materials were not sent for reasons beyond the control of the Plan Administrator. 
 If you have a claim for Benefits, which is
denied or ignored, in whole or in part, and you have exhausted the administrative remedies available under the Plan, you may file suit in a state or federal court. In addition, if you disagree with the Plan’s decision or lack thereof concerning
the qualified status of a domestic relations order, you may file suit in federal court. If it should happen that the Plan’s fiduciaries misuse the Plan’s money, or if you are discriminated against for asserting your rights, you may seek
assistance from the U.S. Department of Labor, or you may file suit in a federal court. 

  
  

			
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 The court will decide who should pay court costs and legal fees. If you are successful, the court may
order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees; for example, if it finds your claim is frivolous. 
 If you have any questions about your Plan, you should contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in
obtaining documents from the Plan Administrator, you should contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in your telephone directory, or write to the Division of Technical Assistance
and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W. Washington, DC 20210. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the
publications hotline of the Employee Benefits Security Administration at (866) 444-3272. 
 The Plan’s Benefits are administered by
Kansas City Life Insurance Company, the Plan Administrator. UnitedHealthcare is the Claims Administrator and processes claims for the Plan and provides appeal services; however, UnitedHealthcare and Kansas City Life Insurance Company are not
responsible for any decision you or your Dependents make to receive treatment, services or supplies, whether provided by a Network or non-Network provider. UnitedHealthcare and Kansas City Life Insurance Company are neither liable nor responsible
for the treatment, services or supplies provided by Network or non-Network providers. 

  
  

			
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 Prescription Drug Program 

Claims are not handled by United HealthCare - see information below. 
 The following Prescription Drug Benefits are administered by CVS Caremark. 

Copayment 
 Retail Program

 $10 for each generic medication. 

$25 for each brand-name medication on the drug list. 
 $40 for each brand-name medication not on the drug list. 
 Mail Service Pharmacy

 $25 for each generic medication. 

$62.50 for each brand-name medication on the drug list. 
 $100 for each brand-name medication not on the drug list. 
 Web Services 

Register at www.caremark.com to access tools that can help you save money and manage your prescription benefit. To register have your benefit ID
card ready. 
 Customer Care 

Call toll-free 1-800-648-2012 or visit www.caremark.com. 
 PRESCRIPTION DRUG PROGRAM 
 The Kansas City Life Employee Medical Plan
offers prescription drug coverage for all covered persons. Please note that the Plan’s Prescription Drug Program does not provide prescription drug coverage for retirees, retirees’ dependents, and surviving spouses if they are eligible for
Medicare. 
 Covered Prescription Drugs 
  

	 	1.	All drugs prescribed by a physician that require a prescription either by federal or state law, except injectables (other than insulin or epi-pen for allergic
reactions) and drugs excluded by the plan. 

  

	 	2.	All compounded prescriptions containing at least one prescription ingredient with a therapeutic quality. 

 

	 	3.	Insulin when prescribed by a physician. 

  

	 	4.	Disposable insulin needles and syringes, if purchased within ninety (90) days of insulin purchase. 

 

	 	5.	Diabetic supplies (blood sugar diagnostics, glucometer strips, lancets, urine test strips). 

 

	 	6.	Tretinoin, all dosage forms (e.g. Retin-A) for covered persons through twenty-five (25) years of age. 

  
  

			
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	 	7.	Prescription oral contraceptives, contraceptive implants (Norplant), diaphragms, and injections. 

 

	 	8.	AIDS-related drugs. 

  

	 	9.	Anabolic steroids. 

  

	 	10.	Fluoride products. 

  

	 	11.	Immunosuppressants. 

  

	 	12.	Prenatal vitamins. 

  

	 	13.	Unit dose drugs 

  

	 	14.	DESI drugs. 

 LIMITS TO THIS
BENEFIT 
 This benefit applies only when a covered person incurs a covered prescription drug charge. The covered drug charge
for any one prescription will be limited to: 
  

	 	1.	Refills only up to the number of times specified by the physician. 

  

	 	2.	Refills up to one year from the date of order by a physician. 

 EXPENSES NOT COVERED 
  

	 	1.	A drug or medicine that can legally be purchased without a written prescription. This does not apply to injectable insulin. 

 

	 	2.	Devices of any type, even though such devices may require a prescription. These include, but are not limited to: therapeutic devices, artificial appliances, braces,
support garments, or any similar device. 

  

	 	3.	Immunization agents or biological sera; blood or blood plasma; or oxygen, including its administration. 

 

	 	4.	A drug or medicine labeled: “Caution – limited by federal law to investigational use.” 

 

	 	5.	Experimental drugs and medicines, even though a charge is made to the covered person. 

 

	 	6.	Any charge for the administration of a covered prescription drug. 

  

	 	7.	Any drug or medicine that is consumed or administered at the place where it is dispensed. 

 

	 	8.	A drug or medicine that is to be taken by the covered person, in whole or in part, while hospital confined. This exclusion applies while being confined in any
institution that has a facility for dispensing drugs. 

  

	 	9.	A charge for prescription drugs which may be properly received without charge under local, state or federal programs. 

 

	 	10.	A charge for hypodermic syringes and/or needles, injectables or any prescription directing administration by injection (other than insulin). 

 

	 	11.	A charge for any smoking cessation product, except as provided and limited herein. 

 

	 	12.	A charge for infertility or impotency medication. 

  

	 	13.	A charge for growth hormones (i.e. Humatrope, Protropin) and any future growth hormone. 

 

	 	14.	A charge for Anorectics (any drug used for the purpose of weight loss). 

  
  

			
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	 	15.	A charge for minerals. 

  

	 	16.	A charge for Minoxidil (Rogaine) for the treatment of alopecia. 

  

	 	17.	A charge for vitamins, singly or in combinations, except prescriptions pre-natal vitamins. 

 Note: The plan’s smoking cessation benefit limit is $500 per lifetime and is only available through the Prescription Drug Program benefit, excluding over-the-counter smoking cessation products.

  
  

			
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