{"formats":[{"name":"JSON","format":"json","url":"\/downloads\/2025\/code-json\/38.2-3466.json"},{"name":"Plain Text","format":"text","url":"\/downloads\/2025\/code-text\/38.2-3466.txt"},{"name":"XML","format":"xml","url":"\/downloads\/2025\/code-xml\/38.2-3466.xml"},{"name":"HTML","format":"html","url":"\/downloads\/2025\/code-html\/38.2-3466.html"}],"law_id":82100,"edition_id":1,"section_id":82100,"structure_id":15137,"section_number":"38.2-3466","catch_line":"License required to provide pharmacy benefits management services; requirements for a license, renewal, and revocation or suspension; civil penalty","history":"2020, cc. 219, 1288; 2024, cc. 329, 626.","full_text":"A\n\nUnless otherwise covered by a license as a carrier, no person shall provide pharmacy benefits management services or otherwise act as a pharmacy benefits manager in the Commonwealth without first obtaining a license in a manner and in a form prescribed by the Commission.B\n\nEach applicant for a license as a pharmacy benefits manager shall make application to the Commission, in the form and containing the information listed in subsection C and any other information the Commission prescribes. The Commission may require any documents reasonably necessary to verify the information contained in an application. Each applicant shall, at the time of applying for a license, pay a nonrefundable application processing fee in an amount and in a manner prescribed by the Commission. The fee shall be collected by the Commission and paid directly into the state treasury and credited to the “Bureau of Insurance Special Fund — State Corporation Commission” for the maintenance of the Bureau of Insurance as provided in subsection B of § 38.2-400.C\n\nAn applicant for a license as a pharmacy benefits manager shall provide the Commission the following information:1\n\nThe name, address, and telephone contact number of the pharmacy benefits manager;2\n\nThe name and address of each person with management or control over the pharmacy benefits manager;3\n\nThe name and address of each person with a beneficial ownership interest in the pharmacy benefits manager; and4\n\nIf the pharmacy benefits manager registrant (i) is a partnership or other unincorporated association, a limited liability company, or a corporation and (ii) has five or more partners, members, or stockholders, the registrant shall specify its legal structure and the total number of its partners, members, or stockholders who, directly or indirectly, own, control, hold with the power to vote, or hold proxies representing 10 percent or more of the voting securities of any other person.D\n\nAn applicant shall provide the Commissioner with a signed statement indicating that, to the best of its knowledge, no officer with management or control of the pharmacy benefits manager has been convicted of a felony or has violated any of the requirements of state law applicable to pharmacy benefits managers, or, if the applicant cannot provide such a statement, a signed statement describing the relevant conviction or violation.E\n\nExcept where prohibited by state or federal law, by submitting an application for a license, the applicant shall be deemed to have appointed the clerk of the Commission as the agent for service of process on the applicant in any action or proceeding arising in the Commonwealth out of or in connection with the exercise of the license. Such appointment of the clerk of the Commission as agent for service of process shall be irrevocable during the period within which a cause of action against the applicant may arise out of transactions with respect to subjects of pharmacy benefits management in the Commonwealth. Service of process on the clerk of the Commission shall conform to the provisions of Chapter 8 (§ 38.2-800 et seq.).F\n\nEach applicant that has complied with the provisions of this article and Commission regulations is entitled to and shall receive a license in the form the Commission prescribes.G\n\nEach pharmacy benefits manager shall renew its license annually and shall, at the time of renewal, pay a renewal fee in an amount and in a manner prescribed by the Commission. The fee shall be collected by the Commission and paid directly into the state treasury and credited to the “Bureau of Insurance Special Fund — State Corporation Commission” for the maintenance of the Bureau of Insurance as provided in subsection B of § 38.2-400.H\n\nThe Commission may refuse to issue or renew a license or may revoke or suspend a license if it finds that the applicant or license holder has not complied with the provisions of this article or Commission regulations.I\n\nA person that violates the provisions of this section may be subject to a civil penalty of $5,000 for each day on which such violation occurs. The Commission may adopt such rules or establish such guidelines as may be necessary to enforce the provisions of this section.","order_by":null,"text":{"0":{"id":294243,"text":"Unless otherwise covered by a license as a carrier, no person shall provide pharmacy benefits management services or otherwise act as a pharmacy benefits manager in the Commonwealth without first obtaining a license in a manner and in a form prescribed by the Commission.","type":"section","prefixes":["A"],"prefix":"A","entire_prefix":"A","prefix_anchor":"A","level":1,"next_prefix":"B"},"1":{"id":294244,"text":"Each applicant for a license as a pharmacy benefits manager shall make application to the Commission, in the form and containing the information listed in subsection C and any other information the Commission prescribes. The Commission may require any documents reasonably necessary to verify the information contained in an application. Each applicant shall, at the time of applying for a license, pay a nonrefundable application processing fee in an amount and in a manner prescribed by the Commission. The fee shall be collected by the Commission and paid directly into the state treasury and credited to the “Bureau of Insurance Special Fund — State Corporation Commission” for the maintenance of the Bureau of Insurance as provided in subsection B of § 38.2-400.","type":"section","prefixes":["B"],"prefix":"B","entire_prefix":"B","prefix_anchor":"B","level":1,"prior_prefix":"A","next_prefix":"C"},"2":{"id":294245,"text":"An applicant for a license as a pharmacy benefits manager shall provide the Commission the following information:","type":"section","prefixes":["C"],"prefix":"C","entire_prefix":"C","prefix_anchor":"C","level":1,"prior_prefix":"B","next_prefix":"C1"},"3":{"id":294246,"text":"The name, address, and telephone contact number of the pharmacy benefits manager;","type":"section","prefixes":["C","1"],"prefix":"1","entire_prefix":"C1","prefix_anchor":"C1","level":2,"prior_prefix":"C","next_prefix":"C2"},"4":{"id":294247,"text":"The name and address of each person with management or control over the pharmacy benefits manager;","type":"section","prefixes":["C","2"],"prefix":"2","entire_prefix":"C2","prefix_anchor":"C2","level":2,"prior_prefix":"C1","next_prefix":"C3"},"5":{"id":294248,"text":"The name and address of each person with a beneficial ownership interest in the pharmacy benefits manager; and","type":"section","prefixes":["C","3"],"prefix":"3","entire_prefix":"C3","prefix_anchor":"C3","level":2,"prior_prefix":"C2","next_prefix":"C4"},"6":{"id":294249,"text":"If the pharmacy benefits manager registrant (i) is a partnership or other unincorporated association, a limited liability company, or a corporation and (ii) has five or more partners, members, or stockholders, the registrant shall specify its legal structure and the total number of its partners, members, or stockholders who, directly or indirectly, own, control, hold with the power to vote, or hold proxies representing 10 percent or more of the voting securities of any other person.","type":"section","prefixes":["C","4"],"prefix":"4","entire_prefix":"C4","prefix_anchor":"C4","level":2,"prior_prefix":"C3","next_prefix":"D"},"7":{"id":294250,"text":"An applicant shall provide the Commissioner with a signed statement indicating that, to the best of its knowledge, no officer with management or control of the pharmacy benefits manager has been convicted of a felony or has violated any of the requirements of state law applicable to pharmacy benefits managers, or, if the applicant cannot provide such a statement, a signed statement describing the relevant conviction or violation.","type":"section","prefixes":["D"],"prefix":"D","entire_prefix":"D","prefix_anchor":"D","level":1,"prior_prefix":"C4","next_prefix":"E"},"8":{"id":294251,"text":"Except where prohibited by state or federal law, by submitting an application for a license, the applicant shall be deemed to have appointed the clerk of the Commission as the agent for service of process on the applicant in any action or proceeding arising in the Commonwealth out of or in connection with the exercise of the license. Such appointment of the clerk of the Commission as agent for service of process shall be irrevocable during the period within which a cause of action against the applicant may arise out of transactions with respect to subjects of pharmacy benefits management in the Commonwealth. Service of process on the clerk of the Commission shall conform to the provisions of Chapter 8 (§ 38.2-800 et seq.).","type":"section","prefixes":["E"],"prefix":"E","entire_prefix":"E","prefix_anchor":"E","level":1,"prior_prefix":"D","next_prefix":"F"},"9":{"id":294252,"text":"Each applicant that has complied with the provisions of this article and Commission regulations is entitled to and shall receive a license in the form the Commission prescribes.","type":"section","prefixes":["F"],"prefix":"F","entire_prefix":"F","prefix_anchor":"F","level":1,"prior_prefix":"E","next_prefix":"G"},"10":{"id":294253,"text":"Each pharmacy benefits manager shall renew its license annually and shall, at the time of renewal, pay a renewal fee in an amount and in a manner prescribed by the Commission. The fee shall be collected by the Commission and paid directly into the state treasury and credited to the “Bureau of Insurance Special Fund — State Corporation Commission” for the maintenance of the Bureau of Insurance as provided in subsection B of § 38.2-400.","type":"section","prefixes":["G"],"prefix":"G","entire_prefix":"G","prefix_anchor":"G","level":1,"prior_prefix":"F","next_prefix":"H"},"11":{"id":294254,"text":"The Commission may refuse to issue or renew a license or may revoke or suspend a license if it finds that the applicant or license holder has not complied with the provisions of this article or Commission regulations.","type":"section","prefixes":["H"],"prefix":"H","entire_prefix":"H","prefix_anchor":"H","level":1,"prior_prefix":"G","next_prefix":"I"},"12":{"id":294255,"text":"A person that violates the provisions of this section may be subject to a civil penalty of $5,000 for each day on which such violation occurs. The Commission may adopt such rules or establish such guidelines as may be necessary to enforce the provisions of this section.","type":"section","prefixes":["I"],"prefix":"I","entire_prefix":"I","prefix_anchor":"I","level":1,"prior_prefix":"H"}},"ancestry":[{"id":15137,"edition_id":1,"name":"Pharmacy Benefits Managers","identifier":"9","label":"article","depth":3,"order_by":1,"parent_id":12993,"metadata":{},"date_created":"2026-06-26 03:52:27","date_modified":"2026-06-26 03:52:27","permalink":{"id":215615,"object_type":"structure","relational_id":15137,"identifier":"9","token":"38.2\/34\/9","url":"\/38.2\/34\/9\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12993,"edition_id":1,"name":"Provisions Relating to Accident and Sickness Insurance","identifier":"34","label":"chapter","depth":2,"order_by":1,"parent_id":12698,"metadata":{},"date_created":"2026-06-26 03:44:07","date_modified":"2026-06-26 03:44:07","permalink":{"id":214887,"object_type":"structure","relational_id":12993,"identifier":"34","token":"38.2\/34","url":"\/38.2\/34\/","edition_id":1,"permalink":0,"preferred":1}},{"id":12698,"edition_id":1,"name":"Insurance","identifier":"38.2","label":"title","depth":1,"order_by":1,"parent_id":null,"metadata":{},"date_created":"2026-06-26 03:43:49","date_modified":"2026-06-26 03:43:49","permalink":{"id":210661,"object_type":"structure","relational_id":12698,"identifier":"38.2","token":"38.2","url":"\/38.2\/","edition_id":1,"permalink":0,"preferred":1}}],"structure_contents":[{"id":60000,"structure_id":15137,"section_number":"38.2-3465","catch_line":"Definitions","url":"\/38.2-3465\/","token":"38.2\/34\/9\/38.2-3465","metadata":false},{"id":82100,"structure_id":15137,"section_number":"38.2-3466","catch_line":"License required to provide pharmacy benefits management services; requirements for a license, renewal, and revocation or suspension; civil penalty","url":"\/38.2-3466\/","token":"38.2\/34\/9\/38.2-3466","metadata":false},{"id":73357,"structure_id":15137,"section_number":"38.2-3467","catch_line":"Prohibited conduct by carriers and pharmacy benefits managers","url":"\/38.2-3467\/","token":"38.2\/34\/9\/38.2-3467","metadata":false},{"id":79303,"structure_id":15137,"section_number":"38.2-3468","catch_line":"Examination of books and records; reports; access to records","url":"\/38.2-3468\/","token":"38.2\/34\/9\/38.2-3468","metadata":false},{"id":57673,"structure_id":15137,"section_number":"38.2-3469","catch_line":"Enforcement; regulations","url":"\/38.2-3469\/","token":"38.2\/34\/9\/38.2-3469","metadata":false},{"id":72179,"structure_id":15137,"section_number":"38.2-3470","catch_line":"Scope of article","url":"\/38.2-3470\/","token":"38.2\/34\/9\/38.2-3470","metadata":false}],"previous_section":{"id":60000,"structure_id":15137,"section_number":"38.2-3465","catch_line":"Definitions","url":"\/38.2-3465\/","token":"38.2\/34\/9\/38.2-3465","metadata":false},"next_section":{"id":73357,"structure_id":15137,"section_number":"38.2-3467","catch_line":"Prohibited conduct by carriers and pharmacy benefits managers","url":"\/38.2-3467\/","token":"38.2\/34\/9\/38.2-3467","metadata":false},"metadata":false,"official_url":"https:\/\/law.lis.virginia.gov\/vacode\/38.2-3466\/","history_text":"

This law was first created in 2020. The record of its establishment is cataloged in chapters 219<\/a> and 1288<\/a> of that year\u2019s edition of \u201cActs of Assembly,\u201d the annual state publication listing all changes made to the Code of Virginia in that year. It has been modified 1 time. Those modifications are cataloged by \u201cThe Acts of Assembly,\u201d a state publication, by year and chapter. Those modifications that can be read on the General Assembly\u2019s website will be linked accordingly. That modification is as follows: in 2024, chapters 329<\/a> and 626<\/a>.<\/p>","references":false,"refers_to":[{"id":54065,"section_number":"38.2-800","catch_line":"Definition","order_by":null,"url":"\/38.2-800\/"}],"permalink":{"id":215621,"object_type":"law","relational_id":82100,"identifier":"38.2-3466","token":"38.2\/34\/9\/38.2-3466","url":"\/38.2-3466\/","edition_id":1,"permalink":0,"preferred":1},"url":"\/38.2-3466\/","token":"38.2\/34\/9\/38.2-3466","dublin_core":{"Title":"License required to provide pharmacy benefits management services; requirements for a license, renewal, and revocation or suspension; civil penalty","Type":"Text","Format":"text\/html","Identifier":"\u00a7 38.2-3466","Relation":"Code of Virginia"},"html":"\n\t\t\t\t\t\t

A.<\/span> Unless otherwise covered by a license as a carrier, no person<\/span> shall provide pharmacy benefits management services or otherwise act as a pharmacy benefits manager in the Commonwealth without first obtaining a license in a manner and in a form prescribed by the Commission<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

B.<\/span> Each applicant for a license as a pharmacy benefits manager shall make application to the Commission<\/span>, in the form and containing the information listed in subsection C and any other information the Commission<\/span> prescribes. The Commission<\/span> may require any documents reasonably necessary to verify the information contained in an application. Each applicant shall, at the time of applying for a license, pay a nonrefundable application processing fee in an amount and in a manner prescribed by the Commission<\/span>. The fee shall be collected by the Commission<\/span> and paid directly into the state<\/span> treasury and credited to the “Bureau of Insurance<\/span> Special Fund — State<\/span> Corporation Commission<\/span>” for the maintenance of the Bureau of Insurance<\/span> as provided in subsection B of § 38.2-400<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

C.<\/span> An applicant for a license as a pharmacy benefits manager shall provide the Commission<\/span> the following information: <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

1.<\/span> The name, address, and telephone contact number of the pharmacy benefits manager; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

2.<\/span> The name and address of each person<\/span> with management or control over the pharmacy benefits manager; <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

3.<\/span> The name and address of each person<\/span> with a beneficial ownership interest in the pharmacy benefits manager; and <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

4.<\/span> If the pharmacy benefits manager registrant (i) is a partnership or other unincorporated association, a limited liability company<\/span>, or a corporation and (ii) has five or more partners, members, or stockholders, the registrant shall specify its legal structure and the total number of its partners, members, or stockholders who, directly or indirectly, own, control, hold with the power to vote, or hold proxies representing 10 percent or more of the voting securities of any other person<\/span>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

D.<\/span> An applicant shall provide the Commissioner<\/span> with a signed statement indicating that, to the best of its knowledge, no officer with management or control of the pharmacy benefits manager has been convicted of a felony<\/span> or has violated any of the requirements of state<\/span> law<\/span> applicable to pharmacy benefits managers, or, if the applicant cannot provide such a statement, a signed statement describing the relevant conviction<\/span> or violation. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

E.<\/span> Except where prohibited by state<\/span> or federal law<\/span>, by submitting an application for a license, the applicant shall be deemed to have appointed the clerk of the Commission<\/span> as the agent for service of process<\/span> on the applicant in any action or proceeding arising in the Commonwealth out of or in connection with the exercise of the license. Such appointment of the clerk of the Commission<\/span> as agent for service of process<\/span> shall be irrevocable during the period within which a cause of action<\/span> against the applicant may arise out of transactions with respect to subjects of pharmacy benefits management in the Commonwealth. Service of process<\/span> on the clerk of the Commission<\/span> shall conform to the provisions of Chapter 8 (§ 38.2-800<\/a> et seq.). <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

F.<\/span> Each applicant that has complied with the provisions of this article and Commission<\/span> regulations is entitled to and shall receive a license in the form the Commission<\/span> prescribes. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

G.<\/span> Each pharmacy benefits manager shall renew its license annually and shall, at the time of renewal, pay a renewal fee in an amount and in a manner prescribed by the Commission<\/span>. The fee shall be collected by the Commission<\/span> and paid directly into the state<\/span> treasury and credited to the “Bureau of Insurance<\/span> Special Fund — State<\/span> Corporation Commission<\/span>” for the maintenance of the Bureau of Insurance<\/span> as provided in subsection B of § 38.2-400<\/a>. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

H.<\/span> The Commission<\/span> may refuse to issue<\/span> or renew a license or may revoke or suspend a license if it finds that the applicant or license holder has not complied with the provisions of this article or Commission<\/span> regulations. <\/i><\/a><\/p><\/section>\n\t\t\t\t\t\t

I.<\/span> A person<\/span> that violates the provisions of this section may be subject to a civil penalty<\/span> of $5,000 for each day on which such violation occurs. The Commission<\/span> may adopt such rules or establish such guidelines as may be necessary to enforce the provisions of this section. <\/i><\/a><\/p><\/section>","plain_text":" CODE OF VIRGINIA\n\nLICENSE REQUIRED TO PROVIDE PHARMACY BENEFITS MANAGEMENT SERVICES; REQUIREMENTS\nFOR A LICENSE, RENEWAL, AND REVOCATION OR SUSPENSION; CIVIL PENALTY (\u00a7\n38.2-3466)\n\nA. Unless otherwise covered by a license as a carrier, no person shall provide\npharmacy benefits management services or otherwise act as a pharmacy benefits\nmanager in the Commonwealth without first obtaining a license in a manner and in\na form prescribed by the Commission.\n\nB. Each applicant for a license as a pharmacy benefits manager shall make\napplication to the Commission, in the form and containing the information listed\nin subsection C and any other information the Commission prescribes. The\nCommission may require any documents reasonably necessary to verify the\ninformation contained in an application. Each applicant shall, at the time of\napplying for a license, pay a nonrefundable application processing fee in an\namount and in a manner prescribed by the Commission. The fee shall be collected\nby the Commission and paid directly into the state treasury and credited to the\n“Bureau of Insurance Special Fund — State Corporation\nCommission” for the maintenance of the Bureau of Insurance as provided in\nsubsection B of § 38.2-400.\n\nC. An applicant for a license as a pharmacy benefits manager shall provide the\nCommission the following information:\n\n 1. The name, address, and telephone contact number of the pharmacy benefits\n manager;\n\n 2. The name and address of each person with management or control over the\n pharmacy benefits manager;\n\n 3. The name and address of each person with a beneficial ownership interest in\n the pharmacy benefits manager; and\n\n 4. If the pharmacy benefits manager registrant (i) is a partnership or other\n unincorporated association, a limited liability company, or a corporation and\n (ii) has five or more partners, members, or stockholders, the registrant shall\n specify its legal structure and the total number of its partners, members, or\n stockholders who, directly or indirectly, own, control, hold with the power to\n vote, or hold proxies representing 10 percent or more of the voting securities\n of any other person.\n\nD. An applicant shall provide the Commissioner with a signed statement\nindicating that, to the best of its knowledge, no officer with management or\ncontrol of the pharmacy benefits manager has been convicted of a felony or has\nviolated any of the requirements of state law applicable to pharmacy benefits\nmanagers, or, if the applicant cannot provide such a statement, a signed\nstatement describing the relevant conviction or violation.\n\nE. Except where prohibited by state or federal law, by submitting an application\nfor a license, the applicant shall be deemed to have appointed the clerk of the\nCommission as the agent for service of process on the applicant in any action or\nproceeding arising in the Commonwealth out of or in connection with the exercise\nof the license. Such appointment of the clerk of the Commission as agent for\nservice of process shall be irrevocable during the period within which a cause\nof action against the applicant may arise out of transactions with respect to\nsubjects of pharmacy benefits management in the Commonwealth. Service of process\non the clerk of the Commission shall conform to the provisions of Chapter 8\n(§ 38.2-800 et seq.).\n\nF. Each applicant that has complied with the provisions of this article and\nCommission regulations is entitled to and shall receive a license in the form\nthe Commission prescribes.\n\nG. Each pharmacy benefits manager shall renew its license annually and shall, at\nthe time of renewal, pay a renewal fee in an amount and in a manner prescribed\nby the Commission. The fee shall be collected by the Commission and paid\ndirectly into the state treasury and credited to the “Bureau of Insurance\nSpecial Fund — State Corporation Commission” for the maintenance of\nthe Bureau of Insurance as provided in subsection B of § 38.2-400.\n\nH. The Commission may refuse to issue or renew a license or may revoke or\nsuspend a license if it finds that the applicant or license holder has not\ncomplied with the provisions of this article or Commission regulations.\n\nI. A person that violates the provisions of this section may be subject to a\ncivil penalty of $5,000 for each day on which such violation occurs. The\nCommission may adopt such rules or establish such guidelines as may be necessary\nto enforce the provisions of this section.\n\nHISTORY: 2020, cc. 219, 1288; 2024, cc. 329, 626.","edition":{"id":1,"name":"2025","slug":"2025","date_created":"2026-06-21 22:39:22","date_modified":"2026-06-21 22:39:22","current":1,"order_by":1,"last_import":null}}