Health Insurance Benefit Coverage Law Summaries
Kansas, Health Insurance Benefit Coverage Law Summaries
Kansas' mandated health care law is codified in the Kansas Statutes Annotated at Chapter 40. Coordination of benefits provisions are located in the Kansas Administrative Regulations at Section 40-4-34.
DEFINITIONS
A “small employer” is any person, firm, corporation, partnership, or association eligible for group sickness and accident insurance that is actively engaged in business and whose total employed workforce consisted of, on at least 50 percent of its working days during the preceding year, of at least two and no more than 50 eligible employees, the majority of whom were employed in Kansas. Companies that are affiliated companies or that are eligible to file a combined tax return for the state are considered one employer (Sec. 40-2209d, as amended by S. 204, L. 1997, effective July 1, 1997).
“Utilization review” means the evaluation of the necessity, appropriateness and efficiency of the use of health care services, procedures and facilities (Sec. 40-22a03).
WHAT THE EMPLOYER MUST DO
Kansas does not require employers to provide health insurance for their employees. However, if an employer does provide insurance, it must be aware of specific coverage required to be included in health insurance policies and contracts. This coverage is summarized below.
Mental health coverage.- Every insurer that issues any group policy of accident and sickness insurance providing medical, surgical or hospital expense coverage for other than specific diseases or accidents only and that provides for reimbursement or indemnity for services rendered to a person covered by such policy in a medical care facility, including HMOs, must provide for reimbursement or indemnity for not less than 30 days per year when such person is confined for treatment of nervous or mental conditions in a licensed medical care facility, community mental health center or clinic, or psychiatric hospital (Sec. 40-2,105, as amended by S. 204, L. 1997, effective July 1, 1997).
Such policy must also provide for reimbursement or indemnity of the costs of treatment of such person for nervous or mental conditions, limited to not less than 100 percent of the first $100, 80 percent of the next $100 and 50 percent of the next $1,640 in any year and limited to not less than $7,500 in such person's lifetime, in the facilities enumerated above when confinement is not necessary, or by a physician or psychologist licensed to practice under Kansas law (Sec. 40-2,105, as amended by S. 204, L. 1997, effective July 1, 1997).
The mandated mental health coverage described above does not apply to any Medicare supplement policy of insurance, nor in the event of an assessment against any person required by a diversion agreement or court order to attend a certified alcohol and drug safety action program (Sec. 40-2,105, as amended by S. 204, L. 1997, effective July 1, 1997).
Parity.- An accident and sickness insurer that offers coverage through a group policy providing hospital, medical or surgical expense benefits that includes mental health benefits is subject to the following requirements (Sec. 40-2258, as amended by S. 102, L. 2007, enacted March 22, 2007):
if the policy does not include an aggregate lifetime limit on substantially all hospital, medical and surgical expense benefits, the policy may not impose any aggregate lifetime limit on mental health benefits;
if the policy includes an aggregate lifetime limit on substantially all hospital, medical and surgical expense benefits, the plan must either (a) apply the applicable lifetime limit both to the hospital, medical and surgical expense benefits to which it otherwise would apply and to mental health benefits and not distinguished in the application of such limit between such hospital, medical and surgical expense benefits and mental health benefits; or (b) not include any aggregate lifetime limit on mental health benefits that is less than the applicable lifetime limit on mental health benefits that is less than the applicable lifetime limit on hospital, medical and surgical expense benefits;
if the policy does not include an annual limit on substantially all hospital, medical and surgical expense benefits, the plan or coverage may not impose any annual limit on mental health benefits; and
if the policy includes an annual limit on substantially all hospital, medical and surgical expense benefits, the policy must either (a) apply the annual limit both to the hospital, medical and surgical expense benefits to which it otherwise would apply and to mental health benefits and not distinguish in the application of such limit between such hospital, medical and surgical expense benefits and mental health benefits; or (b) not include any annual limit on mental health benefits that is less than the applicable annual limit.
If the group policy providing hospital, medical or surgical expense benefits is not otherwise covered above and either does not apply a lifetime or annual benefit or applies different lifetime or annual benefits to different categories of hospital, medical and surgical expense benefits, the Commissioner of Insurance may adopt rules and regulations under which items (2) and (4) above are applied to such policies with respect to mental health benefits by substituting for the applicable lifetime or annual limits an average limit that is computed taking into account the weighted average of the lifetime or annual limits applicable to such categories (Sec. 40-2258, as amended by S. 102, L. 2007, enacted March 22, 2007).
These mental health parity provisions do not apply to group accident and health insurance policies sold to small employers, nor do they apply with respect to a group policy providing hospital, medical or surgical expense benefits if the application of the provisions will result in an increase in the cost under the plan of at least one percent. This section shall not apply to benefits for services furnished on or after December 31, 2007 (Sec. 40-2258, as amended by S. 102, L. 2007, enacted March 22, 2007).
Dependent care coverage.- All group health insurance policies providing coverage on an expense-incurred basis, group service or indemnity type contracts issued by a profit or nonprofit corporation, and all contracts issued by health maintenance organizations organized or authorized to transact business in Kansas that provide coverage for a family member of the enrollee, insured or subscriber must, as to such family members' coverage, also provide that the health insurance benefits applicable for children are payable with respect to a newly born child of the enrollee, insured or subscriber from the moment of birth; a newly born child adopted by the enrollee, insured or subscriber from the moment of birth if a petition for adoption was filed within 31 days of the birth of the child; a child adopted by the enrollee, insured or subscriber from the date the petition for adoption was filed; or, effective July 1, 1997, a child placed in the enrollee's, insured's or subscriber's home by a child placement agency for the purpose of adoption from the date of placement as certified by the enrollee, insured or subscriber. In no case may the time from the date of placement to the date the petition for adoption was filed exceed 280 days (Sec. 40-2,102, as amended by H. 2137, L. 1997, effective July 1, 1997).
The coverage for newly born children must consist of coverage of injury or sickness, including the necessary care and treatment of medically diagnosed congenital defects and birth abnormalities, and routine and necessary immunizations for all newly born children of the insured or subscriber (Sec. 40-2,102, as amended by H. 2137, L. 1997, effective July 1, 1997).
All group health insurance policies providing coverage on an expense-incurred basis, group service or indemnity type contracts issued by a profit or nonprofit corporation, and all contracts issued by health maintenance organizations organized or authorized to transact business in Kansas that provide coverage for a family member of the enrollee, insured or subscriber, as to such family members' coverage, must also offer an option whereby the health insurance benefits include delivery and, effective July 1, 1997, obstetrical, expenses at birth of the birth mother of a child adopted within 90 days of birth of such child by the enrollee, insured or subscriber, subject to the same limitations contained in such policy or contract applicable to the enrollee, insured or subscriber (Sec. 40-2,102, as amended by H. 2137, L. 1997, effective July 1, 1997).
Substance abuse coverage.- Every insurer that issues any group policy of accident and sickness insurance providing medical, surgical or hospital expense coverage for other than specific diseases or accidents only and that provides for reimbursement or indemnity for services rendered to a person covered by such policy in a medical care facility, including HMOs, must provide for reimbursement or indemnity under such policy for not less than 30 days per year when such person is confined for treatment of alcoholism or drug abuse in a licensed medical care facility, treatment facility for alcoholics or drug abusers, or psychiatric hospital (Sec. 40-2,105, as amended by S. 204, L. 1997, effective July 1, 1997).
Such policy must also provide for reimbursement or indemnity of the costs of treatment of such person for alcoholism or drug abuse, limited to not less than 100 percent of the first $100, 80 percent of the next $100 and 50 percent of the next $1,640 in any year and limited to not less than $7,500 in such person's lifetime, in the facilities enumerated above when confinement is not necessary for the treatment, or by a physician or psychologist licensed to practice under Kansas law (Sec. 40-2,105, as amended by S. 204, L. 1997, effective July 1, 1997).
Exceptions.- The mandated substance abuse coverage described above does not apply to Medicare supplement policies of insurance, nor in the event of an assessment against any person required by a diversion agreement or court order to attend a certified alcohol and drug safety action program (Sec. 40-2,105, as amended by S. 204, L. 1997, effective July 1, 1997).
Coordination of benefits.- An employer or the insurer, managed care plan, or third-party administrator that manages a health benefit plan for an employer may share the payment of expenses with another benefit plan sponsored by another employer, with the government through Medicare benefits, or with another type of insurance company through automobile or homeowners' insurance (subrogation). To determine which plan has primary responsibility for payment, coordination of benefits (COB) language specifies the order of benefit payments. Preserving cost management initiatives, such as deductibles and coinsurance, is known as maintenance of benefits. The National Association of Insurance Commissioners (NAIC) has established model guidelines for COB which many states apply to insurance companies, health maintenance organizations, or other health care benefit providers. Self-insured employee benefit plans are not required to adopt coordination of benefits language; however, most self-insured health plans do specify how they will coordinate benefit payments with other plans.
The following types of plans must specify how benefits will be coordinated: group insurance, group subscriber contracts, uninsured arrangements of group or group-type coverages, group or group-type coverage through a health maintenance organization (HMO), and other prepayment, group practice, and individual practice plans, group-type contracts available to a membership in a particular organization or group if the individual does not have a right to maintain or renew the policy independent of continued employment with an employer, group or group-type excess hospital indemnity benefits exceeding $100 per day, group or group-type or individual “no fault” and “fault” contracts, or Medicare or other governmental benefits. A plan shall not include: group-type accident only coverage, individual or family insurance or subscriber contracts, individual HMO coverage, individual or family coverage through prepayment, group practice, or individual practice plans, group or group-type hospital indemnity benefits of $100 per day or less, school accident-type coverages, or a state plan under Medicaid (Kansas Administrative Regulations Sec. 40-4-34).
Order of benefits.- The following priority applies when coordinating health benefit payments (Kansas Administrative Regulations Sec. 40-4-34):
Employee/Dependent: Benefits will be paid first by a health benefit plan, health maintenance organization, or health insurance policy that covers the individual as an employee, subscriber, or member before a plan or policy that covers the individual as a dependent;
Dependent Child/Birthday Rule: For a dependent child whose parents are not separated or divorced and who is covered by two health benefit plans, health maintenance organizations, or health insurance policies, benefits will be paid first by the plan that covers the parent whose birthday month and day is earlier in the calendar year. If both parents have the same birthday, benefits will be paid first by the plan that covered a parent for a longer period of time;
Dependent Child/Divorced or Separated Parents: For a dependent child whose parents are separated or divorced and who is covered by two health benefit plans, health maintenance organizations, or health insurance policies, benefits will be paid first by the plan that covers the custodial parent, second by the plan of the spouse of the custodial parent, and third by the plan of the noncustodial parent. If a court decree states that one of the parents is responsible for health care expenses of the child, benefits will be paid first by the plan of that parent;
Active/Inactive Employee: Benefits will be paid first by a health benefit plan, health maintenance organization, or health insurance policy that covers the individual as an employee who is neither laid off or retired or as that person's dependent before a plan or policy that covers the individual as a laid-off or retired employee or dependent;
Longer/Shorter Length of Coverage: Benefits will be paid first by a health benefit plan, health maintenance organization, or health insurance policy that has covered the individual as an employee, subscriber, or member for a longer period of time before a plan or policy that covered the individual for a shorter period of time; and
Excess Benefits: A complying plan may coordinate its benefits with a plan that is “excess” or “always secondary” or that uses an order of benefit determination provision that is inconsistent with that contained in this rule (called a noncomplying plan), on the following basis: if the complying plan is the primary plan, it must pay or provide its benefits on a primary basis. If the complying plan is the secondary plan, it must still pay or provide its benefits first, as the secondary plan. In such a situation, such payment is the limit of the complying plan's liability, except if the noncomplying plan does not provide the information needed by the complying plan to determine its benefits within a reasonable time after it is requested to do so, the complying plan may assume that the benefits of the noncomplying plan are identical to its own and pay its benefits accordingly. The complying plan must adjust any payments it makes based on such assumption when information becomes available about the actual benefits of the noncomplying plan. If the noncomplying plan pays less in benefits than it would have if the noncomplying plan paid or provided its benefits as the primary plan, the complying plan must advance an amount equal to such difference. However in no event will the complying plan advance more than it would have paid had it been the primary plan less any amount previously paid.
Providers.- Notwithstanding any provision of any individual, group or blanket policy of accident and sickness, medical or surgical expense insurance coverage or any provision of a policy, contract, plan or agreement for medical service, whenever such policy, contract, plan or agreement provides for reimbursement or indemnity for any service that is within the lawful scope of practice of any practitioner licensed under Kansas' Healing Arts Act, reimbursement or indemnification under such policy, contract, plan or agreement must not be denied when such services are performed by an optometrist, dentist or podiatrist acting within the lawful scope of their license (Sec. 40-2,100).
Notwithstanding any provision of any individual, group or blanket policy of accident and sickness, medical or surgical expense insurance coverage or any provision of a policy, contract, plan or agreement for medical service, whenever such policy, contract, plan or agreement provides for reimbursement or indemnity for any service that is within the lawful scope of practice of any practitioner licensed under Kansas' Healing Arts Act, reimbursement or indemnification under such policy contract, plan or agreement must not be denied when such service is rendered by any such licensed practitioner within the lawful scope of his or her license (Sec. 40-2,101).
Psychologists.- Notwithstanding any provision of an individual or group policy or contract of health and accident insurance delivered within Kansas, whenever such policy or contract provides for reimbursement for any service within the lawful scope of practice of a duly licensed psychologist within the state of Kansas, the insured or any other person covered by the policy or contract is allowed and entitled to reimbursement for such service, whether it was provided or performed by a duly licensed physician or a duly licensed psychologist (Sec. 40-2,104).
Social workers.- Notwithstanding any provision of an individual or group policy or contract of health and accident insurance, delivered within Kansas, whenever such policy or contract provides for reimbursement for any service within the lawful scope of practice of a duly licensed specialist social worker authorized to engage in private, independent practice under Kansas law within the state of Kansas, the insured, or any other person covered by the policy or contract is allowed and entitled to reimbursement for such service, whether it was provided or performed by a duly licensed physician or a duly licensed specialist social worker (Sec. 40-2,114).
Nurses.- Notwithstanding any provision of an individual or group policy or contract for health and accident insurance delivered within Kansas, whenever such policy or contract provides for reimbursement for any services within the lawful scope of practice of an advanced registered nurse practitioner within the state, the insured, or any other person covered by the policy or contract, is allowed and entitled to reimbursement for such service, whether it was provided or performed by a duly licensed physician or an advanced registered nurse practitioner. Notwithstanding the provisions of the previous sentence, reimbursement is mandated with respect to services performed by an advanced registered nurse practitioner in Douglas, Johnson, Leavenworth, Sedgwick, Shawnee or Wyandotte counties (Sec. 40-2250).
Preexisting conditions.- No group policy providing hospital, medical or surgical expense benefits issued or renewed within Kansas or issued or renewed outside Kansas and covering Kansas residents may limit or exclude benefits for specific conditions existing at or prior to the effective date of coverage. The policy may impose a preexisting conditions exclusion, not to exceed 90 days following enrollment, for benefits for conditions, whether physical or mental, regardless of the cause of the condition for which medical advice, diagnosis, care or treatment was recommended or received in the 90 days prior to the effective date of coverage. As used in this section, the term “preexisting conditions exclusion” means, with respect to coverage, a limitation or exclusion of benefits relating to a condition based on the fact that the condition was present before the date of enrollment for such coverage whether or not any medical advice, diagnosis, care or treatment was recommended or received before such date. Any preexisting conditions exclusion must run concurrently with any waiting period (Sec. 40-2209, as amended by S. 204, L. 1997, effective July 1, 1997).
An HMO that does not impose any preexisting conditions exclusion may impose an affiliation period for such coverage if the period is applied uniformly without regard to any health status related factors and does not exceed two months. The affiliation period must run concurrently with any waiting period under the plan (Sec. 40-2209, as amended by S. 204, L. 1997, effective July 1, 1997).
Genetic information may not be treated as a preexisting condition in the absence of a diagnosis of the condition related to such information, and a preexisting condition exclusion relating to pregnancy as a preexisting condition is also prohibited (Sec. 40-2209, as amended by S. 204, L. 1997, effective July 1, 1997).
A preexisting condition waiting period may not be imposed in the case of a child who is adopted or placed for adoption before attaining 18 years of age and who, as of the last day of a 30-day period beginning on the date of the adoption or placement, is covered by a group health insurance policy (Sec. 40-2209, as amended by S. 204, L. 1997, effective July 1, 1997).
A preexisting conditions exclusion must be waived to the extent the employee or individual dependent or family member was covered by (1) a group sickness or accident policy, (2) coverage under ERISA, (3) certain professional and trade associations, (4) Part A or Part B of Title XVIII of the Social Security Act, Title XIX of the Social Security Act (in general), (5) a medical care program of the Indian Health Service or a tribal organization, (6) the Kansas Uninsurable Health Plan Act or similar health benefits risk pool of another state, (7) a health plan offered to certain government employees, (8) a health benefit plan under the Peace Corps Act or (9) a group subject to the Kansas Municipal Group-Funded Liability Pool Act that provides hospital, medical and surgical expense benefits within 63 days prior to the effective date of coverage under a health benefit plan with no gap in coverage (Sec. 40-2209, as amended by S. 204, L. 1997, effective July 1, 1997).
Small employers.- Provisions of preexisting conditions may not exclude or limit coverage for a period beyond 90 days following an individual's effective date of coverage, and may only relate to conditions, whether physical or mental, regardless of the cause of the condition for which medical advice, diagnosis, care or treatment was recommended or received, during the six months immediately before the effective date of coverage. Any preexisting conditions exclusion must run concurrently with any waiting period (Sec. 40-2209f, as amended by S. 204, L. 1997, effective July 1, 1997).
A small employer policy may impose a preexisting conditions exclusion, whether physical or mental, regardless of the cause of the condition for which medical advice, diagnosis, care or treatment was recommended or received in the six months prior to the effective date of coverage. The policy must waive such a preexisting conditions exclusion to the extent the employee or member or individual dependent or family member was covered by (1) a group sickness or accident policy, (2) coverage under ERISA, (3) certain professional and trade associations, (4) Part A or Part B of Title XVIII of the Social Security Act, Title XIX of the Social Security Act (in general), (5) a medical care program of the Indian Health Service or a tribal organization, (6 ) the Kansas Uninsurable Health Plan Act or similar health benefits risk pool of another state, (7) a health plan offered to certain government employees, (8) a health benefit plan under the Peace Corps Act or (9) a group subject to the Kansas Municipal Group-Funded Liability Pool Act that provides hospital, medical and surgical expense benefits within 63 days prior to the effective date of coverage under a health benefit plan with no gap in coverage (Sec. 40-2209f, as amended by S. 204, L. 1997, effective July 1, 1997).
Prescription drugs.- An insurance company, nonprofit health service corporation, nonprofit medical and hospital service corporation or HMO that provides coverage for prescription drugs may not issue, deliver, execute or renew any health insurance policy or health service contract on a group basis that excludes coverage of a prescription drug for cancer treatment on the grounds the drug has not been approved by the federal FDA for that covered indication if the drug is recognized for treatment of the indication in one of the standard reference compendia or in substantially accepted peer-reviewed medical literature (Ch. 128 (S. 108), L. 1999, effective May 6, 1999).
Mammograms.- Notwithstanding any provision of any applicable policy, provision, contract, plan or agreement, whenever reimbursement or indemnity for laboratory or x-ray services are covered, reimbursement or indemnification may not be denied for mammograms when performed at the direction of a person licensed to practice medicine and surgery by the Board of Healing Arts within the lawful scope of such person's license, including services performed at a mobile facility certified by the federal Health Care Financing Administration and performing mammography testing by American Cancer Society guidelines (Secs. 40-2229 and 40-2230).
Mastectomies.- Any group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society or HMO that provides coverage for accident and health services and that is delivered, issued for delivery, amended or renewed on or after July 1, 1999, and that provides medical and surgical benefits with respect to a mastectomy must provide, in a case of a participant or beneficiary who is receiving benefits in connection with a mastectomy and who elects breast reconstruction in connection with such mastectomy, coverage for (Sec. 2, S. 3, L. 1999):
reconstruction of the breast on which the mastectomy has been performed;
surgery and reconstruction of the other breast to produce a symmetrical appearance; and
prostheses and physical complications in all stages of mastectomy, including lymphedemas.
Maternity benefits: Minimum inpatient care.- Any health plan that provides coverage for maternity services, including benefits for childbirth, must provide coverage for at least 48 hours of inpatient care following a vaginal delivery and at least 96 hours of inpatient care following delivery by caesarean section for a mother and newly born child in a medical care facility. Any decision to shorten the length of inpatient stay to less than that described above must be made by the attending physician. No health plan may terminate the service of or otherwise penalize any attending physician who orders care that is consistent with this requirement (Sec. 1, S.B. 573, L. 1995).
Plans that provide coverage for postdelivery care for a mother and her newly born child in the home are not required to provide inpatient care as described above, unless inpatient care is determined to be medically necessary by the attending physician (Sec. 1, S.B. 573, L. 1995).
Written notice of these requirements must be given by all health plans (Sec. 1, S.B. 573, L. 1995).
Osteoporosis.- Any group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society or HMO, municipal group-funded pool and the state employee health care benefits plan which provides coverage for hospital, medical and surgical services, other than medicare supplement or accident-only policies that are delivered, issued for delivery, amended or renewed on or after July 1, 2001, must include coverage for services related to diagnosis, treatment and management of osteoporosis when such services are provided by a person licensed to practice medicine and surgery in Kansas, for individuals with a condition or medical history for which bone mass measurement is medically necessary for such individual (Sec. 2, S. 19, L. 2001).
Cervical cancer screenings.- Notwithstanding any provision of any applicable policy, provision, contract, plan or agreement, whenever reimbursement or indemnity for laboratory or x-ray services are covered, reimbursement or indemnification may not be denied for pap smears when performed at the direction of a person licensed to practice medicine and surgery by the Board of Healing Arts within the lawful scope of such person's license (Secs. 40-2229 and 40-2230).
Dental care.- Any group health insurance policy, medical service plan, contract, hospital service corporation contract, hospital and medical service corporation contract, fraternal benefit society or HMO that provides coverage for accident and health services and that is delivered, issued for delivery, amended or renewed on or after July 1, 1999, also must provide coverage for the administration of general anesthesia and medical care facility charges for dental care provided to the following covered persons (Sec. 1, S. 3, L. 1999):
a child five years of age and under; or
a person who is severely disabled; or
a person who has a medical or behavioral condition that requires hospitalization or general anesthesia when dental care is provided.
Utilization review: Certification of UR agents.- To promote delivery of quality health care in a cost-effective manner, assure that utilization review agents adhere to reasonable standards, foster coordination and cooperation between health care providers and UR agents, improve communication among all parties, and ensure that medical records are kept confidential, Kansas requires UR agents to be certified annually and adhere to minimum standards (Secs. 40-22a01-40-22a12). No certificate is required for utilization review activities conducted by or on behalf of an agency of the federal government; a person, agency or utilization review organization acting on behalf of the federal government, if such person, agency or organization is providing services under federal regulation; a federally qualified health maintenance organization authorized to transact business in Kansas that is administering a quality assurance program and performing utilization review activities for its own members; a person employed or used by a utilization review organization authorized to perform utilization review in Kansas, including, but not limited to, individual nurses and other health care providers (Sec. 40-22a06).
Confidentiality of medical records.- UR agents must protect the confidentiality of individual medical records (Sec. 40-22a09).
Emergency care.- A health benefit plan may not deny coverage for emergency services if the symptoms presented by an insured and recorded by the attending provider indicate that an emergency medical condition exists, or for emergency services necessary to provide an insured with a medical examination and stabilizing treatment, regardless of whether prior authorization was obtained to provide those services (Sec. 18, S. 204, L. 1997, effective July 1, 1997).
Social security number use.- On and after July 1, 2006 (Secs. 3 and 4, H. 2549, L. 2003, enacted May 17, 2004):
no insurance company, including HMOs, offering any type of accident and sickness policy covering individuals residing in Kansas or offering any type of coverage for prescription drugs or devices covering individuals residing in Kansas shall print or encode an insured's social security number on or into the insured's policy card.
any distinguishing identifier assigned to the insured's policy card shall be a combination of numbers or letters or both, which is unique to the insured.
an insured's distinguishing identifier assigned to such insured's policy card shall not, in any way, be based on or depend on the insured's social security number.
WHO TO CONTACT
Contact the Insurance Department at 420 SW Ninth Street, Topeka, KS 66612-1678. Telephone: (785) 296-3071. Fax: (785) 296-2283.
<p>Contact the Insurance Department at 420 SW Ninth Street, Topeka, KS 66612-1678. Telephone: (785) 296-3071. Fax: (785) 296-2283.</p>
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