Pharmacy Benefits Managers


EFFECTIVE JULY 1, 2021

Pharmacy Benefits Manager (PBM) means a person, business, or 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 residents of this state for health benefit plans.

PBMs are regulated by the Commissioner of Insurance. Effective July 1, 2021 all PBMs established or operating in this state must obtain a license from the commissioner and, starting October 1, 2021, all PBM contracts must comply with the requirements of Act 2021-341.

The PBM application must be completed and filed along with copies of the applicant’s corporate charter, articles of incorporation, or other charter documents.

A non-refundable fee will be due at the time of filing as indicated on the application form.

PBM licenses must be renewed annually along with payment of a nonrefundable license renewal fee.