EFFECTIVE JULY 1, 2021
Pharmacy Benefits Manager (PBM), as defined in Ala. Code Section 27-45A-3(9) located at: http://alisondb.legislature.state.al.us/alison/CodeOfAlabama/1975/27-45A-3.htm,
is a person or business entity, including a wholly or partially owned or controlled subsidiary of a pharmacy benefits manager, that provides claims processing services or other
prescription drug or device services, or both to covered individuals who are employed in or are resident of this state for health benefit plans.
PBMs are regulated by the Commissioner of Insurance. A person may not establish or operate as a pharmacy benefits manager in Alabama without first obtaining a license from the
Commissioner. Additionally, all PBM contracts must comply with the requirements of Act 2021-341.
The Initial PBM application must be completed and filed along with copies of the applicant’s corporate charter, articles of incorporation, or other charter documents.
The initial fee for a pharmacy benefits manager license is nonrefundable and is hereby set at $500.00. PMBs may apply for initial licensure here:
PHARMACY BENEFITS MANAGERS LICENSE RENEWALS
Pharmacy Benefit Manager Initial Application
Pharmacy Benefits Manager licenses are required to be renewed annually along with the payment of a nonrefundable license renewal fee. No later than July 1 of each year, licensees
must report their Alabama state annual gross pharmacy benefit manager business income for the previous calendar year. This report will be held by the Commissioner as confidential
and not subject to public inspection in accordance with Alabama Code Section 27-45A-4(k).
The Commissioner will charge the proportionate share of the annual cost of PBM licensee renewal and oversight activities to all existing PBM licensees. A licensee’s proportionate
share shall be based on its Alabama state annual gross pharmacy benefit manager business income for the previous calendar year. The minimum renewal fee is $500, regardless of the
PBM had business income in Alabama the previous calendar year or not.
On or about November 1st of each year, all PBM license renewal fees will be calculated based on the proportionate share of the annual cost of renewal and oversight activities. Each Pharmacy
Benefit Manager will receive a renewal notice informing them of the renewal fee and notice that the renewal portal is now open. All PBM license renewals shall be accomplished before
December 31 of each calendar year. The online renewal portal will be available here on our website at a later date.
A Certificate of Renewal will be emailed to each Pharmacy Benefit Manager for their records.
Changes in information regarding the Pharmacy Benefit Manager must be reported to the Department within 30 days. While there is no filing fee for reporting such changes, there is a
penalty of $50 for the failure to report said changes within 30 days.
To report changes (name, contact information, address, amendments, corporate changes, etc.) please email the Department at ExaminationDivision@insurance.alabama.gov.