MO SB642

Health carriers with 50,000+ insured persons must spend at least 90% of Missouri-associated revenue on health care services, with non-health expenditures not exceeding 10%

Health carriers with 25,000-50,000 insured persons must spend at least 85% of Missouri-associated revenue on health care services, with non-health expenditures not exceeding 15%

Health carriers must report annually to the Director of Insurance their total revenues, Missouri-associated revenue, health expenditures, and calculated care share percentages

Carriers failing to meet required spending percentages must refund the difference to insured persons by April 30th of the following year, or reduce premiums by the shortfall amount

Violations constitute level four violations under Missouri insurance law; Director may audit 10% of carriers annually and assess fees to cover monitoring costs