Pharmacy Benefits Manager (PBM) refers to a person or entity that manages prescription drug benefits on behalf of a covered entity.
License Requirements
Pharmacy Benefit Managers must obtain a license from the North Dakota Insurance and Securities Department before operating in North Dakota. N.D.C.C. §§ 26.1-27.1-01 through 26.1-27.1-07
Applying for the License/License Term
You can submit an application through the National Insurance Producer Registry (NIPR).
Applicants must provide identity details, contact information, and evidence of financial responsibility of $1 million.
PBM licenses are issued for a one-year term beginning April 30 and expiring March 31 of the following year. Licenses are nontransferable.
The initial and renewal fee is $10,000. All fees are nonrefundable and must accompany the application or renewal submission.
Renewal of License
PBM licenses must be renewed annually. Renewal fees are due no later than April 30. Failure to renew timely may result in license expiration or enforcement action.
Enforcement and Penalties
The Insurance Commissioner has examination, investigation, and subpoena authority to enforce PBM licensing laws.
Violations may result in:
- Monetary penalties up to $10,000 per violation
- Suspension or revocation of license
- Civil penalties up to $50,000 for second or subsequent violations
- Restitution to affected covered entities, pharmacies, or individuals