Missouri employer health plans: what they cost and who gets paid
Updated plan year 2024, the most recent complete year
1,063 Missouri employers filed health plans with 100 or more participants for plan year 2024, covering 1,470,031 participants. They reported $388M in insurance premiums and $118M in broker commissions and fees. The median broker rate on commission-paying, fully insured medical plans was 4.5% of premium, 0.8 points above the national median of 3.8%.
Largest brokers
Reported commissions and fees, with the number of employer plans naming each.
Largest medical carriers
Medical premium written.
Cities in Missouri
Every Missouri city where 15 or more employers filed a health plan, by the sponsor's mailing address. Each page lists the city's largest plans, brokers and carriers.
| City | Employer plans | Premiums |
|---|---|---|
| St. Louis | 295 | $15M |
| Kansas City | 184 | $173M |
| Springfield | 62 | $25M |
| Columbia | 37 | $1.8M |
| Chesterfield | 36 | $2.6M |
| Maryland Heights | 23 | $4.2M |
| Fenton | 21 | $3.1M |
| St. Charles | 21 | $1.1M |
| Earth City | 18 | $62M |
| St. Joseph | 15 | $5.6M |
Largest employer plans
By health plan participants.
Highest broker pay
Employers reporting the most broker commissions and fees.
Highest commission rates
Fully insured medical plans with at least $500,000 in premium, ranked by broker compensation as a share of premium.
Source: DOL Form 5500 and Schedule A, plan year 2024; built October 24, 2026. Methodology.
What do Missouri employers pay health insurance brokers?
Across 69 fully insured medical plans in plan year 2024, among commission-paying fully insured medical plans, the median broker compensation for Missouri employers was 4.5% of premium (middle half 2.8% to 5.9%), against a national median of 3.8%. In dollars, the median employer that disclosed broker pay reported $64,776.
Which Missouri employers paid the most in broker commissions?
TKC Holdings, Inc. reported the most in 2024, $1,924,604, followed by Lester E Cox Medical Center ($1.8M) and Cornerstone Employer Solutions, LLC ($1.4M).
Which brokers and carriers dominate Missouri?
By reported compensation, the largest brokers are Lockton, Marsh McLennan Agency, Mercer. By medical premium, the largest carriers are Blue Cross Blue Shield of Kansas City, Blue Cross Blue Shield, Cox Health Systems Insurance Company.
Which Missouri cities have the most employer health plans?
St. Louis (295 employer plans, $15M in premiums); Kansas City (184 employer plans, $173M in premiums); Springfield (62 employer plans, $25M in premiums); Columbia (37 employer plans, $1.8M in premiums); Chesterfield (36 employer plans, $2.6M in premiums). 10 Missouri cities with 15 or more employer plans have their own page listing the largest plans, brokers and carriers.
Is your company on this page? Get its Form 5500 read next to the Missouri medians.
Tell us the company and a specialist writes up what the public Form 5500 record shows for it, if it files one: broker pay against the medians above, fee disclosure and filing timeliness, in a form you can forward to your CFO or counsel. Tick the box if you also want a 15-minute walkthrough call.
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