Licensing

Pharmacy Benefits Manager Licensing

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PBM Licensing Information and Instructions

Initial License

Pharmacy Benefits Managers Checklist

Pharmacy Benefits Managers FAQs

To apply for a Kansas Pharmacy Benefits Manager (PBM) license, the applicant must satisfy or complete the following requirements:

  1. The applicant must be organized as a corporation, partnership, limited liability company, limited liability partnership or sole proprietorship. If applicable, register your business entity with the Kansas Secretary of State’s office (Sole Proprietors and partnerships are not required to file/register with the Secretary of State). Note: The applicant is required to submit a Certificate of Good Standing to the Department via email to KDOI.rf@ks.gov with “Certificate of Good Standing” in the subject of the email.
  2. Submit the NAIC Uniform Application for Business Entity License online via the National Insurance Producer Registry (NIPR). Submit background question responses and administrative actions to the NIPR Data Warehouse, if applicable.
  3. At the time of application, the applicant must pay an application fee of $2,500 by credit card or electronic check through NIPR. The application fee is nonrefundable.
  4. Submit an EIN Verification Letter (147C) issued by the IRS or any other acceptable document issued by the IRS verifying the entity’s FEIN by email to KDOI.rf@ks.gov or upload to the attachments warehouse. This document is required for all business entity types, including sole proprietorships. To obtain a copy of the EIN Verification letter call 1-800-829-4933.
  5. The following information must be submitted electronically to the Department via the fillable Contacts Form:
    1. Name, address, official position and professional qualifications of each individual who is responsible for the conduct of the affairs of the PBM, including all members of the board of directors, board of trustees, executive committee, other governing board or committee, the principal officers in the case of a corporation, the partners or board members in the case of a partnership or association.
    2. Name and address of the applicant’s agent for service of process in the state of Kansas.
    3. Name, address, phone number, email address and official position of the PBM employee who will serve as the primary contact for the Department.
  6. Complete and electronically submit the Network Adequacy Report Form.
  7. Submit the following documents to the Department via email to KDOI.rf@ks.gov with “PBM” in the subject line:
    1. A copy of the PBM’s corporate charter, articles of incorporation or other charter documents.
    2. A template contract, which shall include the dispute resolution process, involving an independent factfinder between:
      1. the PBM and the health insurer; or
      2. the PBM and the pharmacy or the pharmacy’s contracting agent.
    3. A listing of affiliated and independent pharmacies to complete network adequacy report.

Review by the Department

The Department has 90 days after receipt of the applicable license fee, the network adequacy report and a “completed application” to review the applicant’s qualifications and either issue a license for applicants who meet the requirements for licensure or issue a denial letter, documenting reasons for the determination.