Pharmacy Benefit Manager License System


For new applications, you will need..

  • PBM's corporate charter, articles of incorporation, and other charter documents
  • If applicable, documents pertaining to refusal/denial of registration, license, or certification
  • If applicable, documents pertaining to termination of insurer or pharmacy benefit manager
  • Click here  for a sample of the information needed.

All documents must be in PDF format only! 

Please have documents ready before beginning application to prevent session timeout.