Effective September 15, 2025, Washington now allows a resident and non-resident licensing for a pharmacy benefit manager (PBM). Requirements are below:

• PBM's must register with the Office of the Insurance Commissioner (OIC) and annually renew the registration.
• A PBM is a subtype of health care benefit managers (HCBMs).
• A "PBM" is a person who contracts with pharmacies on behalf of a health carrier, employee benefits program, or Medicaid managed care program to:
• Process claims for prescription drugs or medical supplies or provide retail network management for pharmacies or pharmacists;
• Pay pharmacies or pharmacists for prescription drugs or medical supplies;
• Negotiate rebates, discounts, or other price concessions with manufacturers for drugs paid for or procured as discussed in WA ST 48.200.020(14)(a);
• Establish or manage pharmacy networks; or
• Make credentialing determinations.
• PBMs must comply with the requirements set forth in:
• WA ST 48.200.030 - WA ST 48.200.050 Health Care Benefit Managers; and
• WA ST 48.200.220 - WA ST 48.200.320 (PBM requirements).

Our compliance experts are constantly searching for and analyzing industry updates. Their findings are then recorded in the Regulatory Updates section of the Compliance Library to explain how the update impacts the insurance industry. If a change impacts an AgentSync product, this will be highlighted to inform you that the product is being updated to ensure you remain in compliance.