Pharmacy Benefits Managers

The Maine Bureau of Insurance provides on this page all of the information necessary to register a Pharmacy Benefits Manager. Contact Us if you have questions or are unable to find what you are looking for.

Important Notice:  Starting 2023, renewal notices will be emailed.  Please contact Violet Hyatt at violet.m.hyatt@maine.gov to update your contact information by 12/31/22.

Application

• Pharmacy Benefits Manager (PBM) Application Checklist (PDF)
• Pharmacy Benefits Manager (PBM) License Application (PDF)

Fiduciary Agreement

• Rule 210 - Fiduciary Agreement Form (PDF)

Fees

• Fee Schedule - (Scroll to Item 28)
• Authorization of Credit Card Payment (PDF)

Update License Information

• Change your contact information, affiliations, and responsible individual

Annual Reporting Requirements

• Any Willing Pharmacy (Bulletin 377)

Requesting Confidential Treatment of Documents

• Instructions for requesting confidential treatment of documents

Statutory Requirements

• 24-A M.R.S. §§ 4347-4350-E (Licensure of Pharmacy Benefits Managers)

The documents on this page are also available in hard copy by contacting the Bureau.