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MissouriHB25962026 Regular SessionHouseWALLET

Modifies provisions relating to health benefit plans

Sponsored By: Peggy McGaugh (Republican)

Signed by Governor

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Bill Overview

Analyzed Economic Effects

3 provisions identified: 2 benefits, 0 costs, 1 mixed.

Longer birth control supplies for plan members

The law sets longer supply rules for Missouri multiple-employer self-insured plans that cover self-administered hormonal birth control. For plans delivered, issued, continued, or renewed starting January 1, 2026, reimbursement must cover supplies up to 90 days. Generic supplies can last up to 180 days; these temporary limits expire December 31, 2026. For plans delivered, issued, continued, or renewed starting January 1, 2027, reimbursement must cover up to a one-year supply. That rule covers both generic and brand-name drugs. Deductibles and copayments cannot exceed those for similar health care services. The rules cover FDA-approved hormonal drugs to prevent pregnancy, excluding emergency contraception and drugs approved to end pregnancy.

More shared health plans for small businesses

Missouri law expands which arrangements qualify as multiple-employer self-insured health plans. These plans can offer health, dental, or short-term disability benefits to workers, qualifying self-employed people, and their dependents. One qualifying arrangement covers employees of at least two employers and at least two self-employed people. Each self-employed person must have at least one common-law employee. Plans offered by staff or employee leasing companies also qualify when they are not fully insured. A plan is fully insured only when a Missouri-licensed insurer has final responsibility for paying benefits under its contract.

Shared health plans face stronger financial safeguards

Missouri multiple-employer self-insured health plans must hold surplus funds of at least $600,000 or twice their authorized control level risk-based capital, whichever is greater. This capital measure is tied to the plan's financial risks. Plans must also reserve money for incurred claims, including unreported claims, and premiums collected for coverage not yet provided. Funds must be held in trust, overseen by three to seven trustees elected by participating employers. Trustees must be plan participants, with no employer represented more than once and no trustee representing multiple employers. Trustees cannot be agents, brokers, owners, officers, or employees of administrators, insurance agencies, or insurers used by the plan. Each trustee needs a bond of at least $150,000 from a licensed insurer and receives no pay beyond actual expense reimbursement. Trustees can approve employer applications and hire licensed third-party administrators for daily operations. Investments must follow Missouri insurer restrictions and be managed by a Missouri-licensed bank or investment entity. Out-of-state plans qualify for an investment-law exemption only when their home-state laws are substantially similar to Missouri's specified requirements. Plans must file annual financial and capital reports with Missouri's Department of Commerce and Insurance director by March 1.

Sponsors & Cosponsors

Sponsor

  • Peggy McGaugh

    Republican • House

Cosponsors

  • Ann Kelley

    Republican • House

  • Burt Whaley

    Republican • House

  • George Hruza

    Republican • House

  • John Hewkin

    Republican • House

  • Sherri Gallick

    Republican • House

Roll Call Votes

All Roll Calls

Yes: 493 • No: 74

Senate vote • 5/13/2026

Truly Agreed To and Finally Passed

Yes: 22 • No: 10

Senate vote • 5/13/2026

Senate Adopts Conference Committee Report

Yes: 23 • No: 8

House vote • 5/13/2026

Third Read and Passed

Yes: 119 • No: 27

House vote • 5/13/2026

House Adopts Conference Committee Report

Yes: 120 • No: 26

House vote • 5/13/2026

Reported Do Pass

Yes: 8 • No: 0

House vote • 4/20/2026

Reported Do Pass

Yes: 6 • No: 1 • Other: 1

Senate vote • 4/15/2026

Third Read and Passed with Amendments - SA 1, SA 2, adopted

Yes: 26 • No: 2

House vote • 2/19/2026

Third Read and Passed

Yes: 145 • No: 0

House vote • 2/10/2026

Reported Do Pass

Yes: 9 • No: 0

House vote • 1/29/2026

HCS Reported Do Pass

Yes: 15 • No: 0

Actions Timeline

  1. Delivered to Secretary of State (G)

    7/13/2026House

  2. Approved by Governor (G)

    7/13/2026House

  3. Delivered to Governor

    5/28/2026House

  4. Signed by President Pro Tem

    5/28/2026Senate

  5. Signed by House Speaker

    5/28/2026House

  6. Senate Message

    5/13/2026Senate

  7. Truly Agreed To and Finally Passed - AYES: 22 NOES: 10 PRESENT: 0

    5/13/2026Senate

  8. Senate Adopts Conference Committee Report - AYES: 23 NOES: 8 PRESENT: 0

    5/13/2026Senate

  9. Senate Submits Conference Committee Report

    5/13/2026Senate

  10. Conferees to Exceed Differences - in Section 1 of SS HCS HB 2596

    5/13/2026Senate

  11. House Message

    5/13/2026House

  12. House Message

    5/13/2026House

  13. Third Read and Passed - AYES: 119 NOES: 27 PRESENT: 0

    5/13/2026House

  14. House Adopts Conference Committee Report - AYES: 120 NOES: 26 PRESENT: 0

    5/13/2026House

  15. Conferees to Exceed Differences - in Section 1 of SS HCS HB 2596

    5/13/2026House

  16. House Submits Conference Committee Report

    5/13/2026House

  17. Reported Do Pass - AYES: 8 NOES: 0 PRESENT: 0

    5/13/2026House

  18. Voted Do Pass

    5/13/2026House

  19. Executive Session Completed

    5/13/2026House

  20. Referred: Fiscal Review

    5/12/2026House

  21. House Distributes Conference Committee Report

    5/12/2026House

  22. House Message

    5/7/2026House

  23. House Conference Committee Appointed - REPRESENTATIVES MCGAUGH, MILLER, DIEHL, MACKEY, BUSH

    5/7/2026House

  24. Senate Message

    4/27/2026Senate

  25. Senate Conference Committee Appointed - CRAWFORD, GREGORY(21), TRENT, MCCREERY, LEWIS

    4/27/2026Senate

Bill Text

  • Truly Agreed

    5/13/2026

    PDF

  • Perfected

    2/17/2026

    PDF

  • Committee Substitute

    1/29/2026

    PDF

  • Senate Substitute

    1/29/2026

    PDFPDF

  • Introduced

    1/7/2026

    PDF

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