Missouri Consolidated Health Care Plan

The agenda for the open session of the board meeting includes the Election of the Chairperson and Vice-Chairperson, the Executive Director Report, Final Orders of Rulemaking, a Financial Update, and Public Entity Business. The board also plans to move into an executive session to discuss confidential matters, including privileged communications with legal counsel, specifications for competitive bidding, and records protected from disclosure by law.

The meeting included announcements such as the Certificate of Achievement for Excellence in Financial Reporting awarded by the Government Finance Officers Association for MCHCP's Annual Comprehensive Financial Report for the fiscal year ended June 30, 2024, and the 2026 Board of Trustees Calendar. The agenda included the approval of minutes from the October 23, 2025, Board of Trustees Meeting, an Executive Director Report, a FY 2027 Appropriation Request Update, an External Audit and FY 2025 Annual Comprehensive Financial Report, and a Financial Update. The board moved into executive session to discuss confidential communications with its attorney, specifications for competitive bidding, and records protected from disclosure by law.

The meeting included the Executive Director's report, which provided updates on the Governor's budget meeting, the Express Scripts contract, and preparations for the pharmacy benefit manager (PBM) request for proposal (RFP). An open enrollment update was also presented. The board authorized the executive director to finalize rules for the 2026 plan year and approved the renewal of the external auditor contract with Armanino. Additionally, the board authorized MCHCP to contract with Foundational Pharmacy Strategies for short-term consulting services related to the PBM. A financial update, including a review of August 2025 preliminary results, was provided.

The board meeting included updates on member claims submitted to Anthem, the upcoming Open Enrollment (OE) member communications and website launch, and ongoing negotiations with Express Scripts. An agreement was reached with Jefferson City Medical Group (JCMG) and UnitedHealthcare (UHC) for Medicare Advantage plan members. The board reviewed meetings with pharmacy benefit manager vendors and discussed the creation of an RFP with assistance from Segal, the actuary. The contract renewal for banking and investment services with Central Bank was approved. The fiscal year (FY) 2027 appropriation request was presented and approved. The dashboard report comparing calendar year (CY) 2024 to CY 2023 data, along with GLP-1 utilization and plan payments, was reviewed. The financial update included a review of July 2025 preliminary results.

The board meeting included discussions regarding a meeting with MU Health Care and Anthem to resolve billing and claims issues, Open Enrollment member communications, ongoing reviews of the Pharmacy Benefit Manager (PBM) program with MO HealthNet Division, PBM vendor meetings, the implementation of Anthem's Headway program for virtual behavioral health care, and the Virtual 5K Charity event. The board also considered new Public Entity (PE) applications, the contract renewal for the Pharmacy Benefit Manager with Express Scripts, and the recommendation to discontinue the SmartShopper program. Additionally, the 2025 Audit Plan was presented, and the GFOA Certificate of Achievement for Excellence in Financial Reporting was received for the fiscal year ending June 30, 2024. A financial update, including July 2025 preliminary results, was provided.