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<law><site_title>Virginia Decoded</site_title><site_url>https://vacode.org</site_url><law_id>82100</law_id><section_number>38.2-3466</section_number><catch_line>License required to provide pharmacy benefits management services; requirements for a license, renewal, and revocation or suspension; civil penalty</catch_line><edition url="https://vacode.org/2025/" slug="2025" current="TRUE" last_updated="">2025</edition><structure><unit label="title" level="1" order_by="1" identifier="38.2">Insurance</unit><unit label="chapter" level="2" order_by="1" identifier="34">Provisions Relating to Accident and Sickness Insurance</unit><unit label="article" level="3" order_by="1" identifier="9">Pharmacy Benefits Managers</unit></structure><text>
						<section id="A"><p><span class="prefix-number">A.</span> Unless otherwise covered by a license as a carrier, no <span class="dictionary">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 <span class="dictionary">Commission</span>. <a id="paragraph-294243" class="section-permalink" href="https://vacode.org/38.2-3466/#A"><i class="fa fa-link"/></a></p></section>
						<section id="B"><p><span class="prefix-number">B.</span> Each applicant for a license as a pharmacy benefits manager shall make application to the <span class="dictionary">Commission</span>, in the form and containing the information listed in subsection C and any other information the <span class="dictionary">Commission</span> prescribes. The <span class="dictionary">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 <span class="dictionary">Commission</span>. The fee shall be collected by the <span class="dictionary">Commission</span> and paid directly into the <span class="dictionary">state</span> treasury and credited to the &#x201C;<span class="dictionary">Bureau of Insurance</span> Special Fund &#x2014; <span class="dictionary">State</span> Corporation <span class="dictionary">Commission</span>&#x201D; for the maintenance of the <span class="dictionary">Bureau of Insurance</span> as provided in subsection B of &#xA7; <a class="law" title="Expense of administration of insurance laws borne by licensees; minimum contribution" href="/38.2-400/">38.2-400</a>. <a id="paragraph-294244" class="section-permalink" href="https://vacode.org/38.2-3466/#B"><i class="fa fa-link"/></a></p></section>
						<section id="C"><p><span class="prefix-number">C.</span> An applicant for a license as a pharmacy benefits manager shall provide the <span class="dictionary">Commission</span> the following information: <a id="paragraph-294245" class="section-permalink" href="https://vacode.org/38.2-3466/#C"><i class="fa fa-link"/></a></p></section>
						<section id="C1" class="indent-1"><p><span class="prefix-number">1.</span> The name, address, and telephone contact number of the pharmacy benefits manager; <a id="paragraph-294246" class="section-permalink" href="https://vacode.org/38.2-3466/#C1"><i class="fa fa-link"/></a></p></section>
						<section id="C2" class="indent-1"><p><span class="prefix-number">2.</span> The name and address of each <span class="dictionary">person</span> with management or control over the pharmacy benefits manager; <a id="paragraph-294247" class="section-permalink" href="https://vacode.org/38.2-3466/#C2"><i class="fa fa-link"/></a></p></section>
						<section id="C3" class="indent-1"><p><span class="prefix-number">3.</span> The name and address of each <span class="dictionary">person</span> with a beneficial ownership interest in the pharmacy benefits manager; and <a id="paragraph-294248" class="section-permalink" href="https://vacode.org/38.2-3466/#C3"><i class="fa fa-link"/></a></p></section>
						<section id="C4" class="indent-1"><p><span class="prefix-number">4.</span> If the pharmacy benefits manager registrant (i) is a partnership or other unincorporated association, a limited liability <span class="dictionary">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 <span class="dictionary">person</span>. <a id="paragraph-294249" class="section-permalink" href="https://vacode.org/38.2-3466/#C4"><i class="fa fa-link"/></a></p></section>
						<section id="D"><p><span class="prefix-number">D.</span> An applicant shall provide the <span class="dictionary">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 <span class="dictionary">felony</span> or has violated any of the requirements of <span class="dictionary">state</span> <span class="dictionary">law</span> applicable to pharmacy benefits managers, or, if the applicant cannot provide such a statement, a signed statement describing the relevant <span class="dictionary">conviction</span> or violation. <a id="paragraph-294250" class="section-permalink" href="https://vacode.org/38.2-3466/#D"><i class="fa fa-link"/></a></p></section>
						<section id="E"><p><span class="prefix-number">E.</span> Except where prohibited by <span class="dictionary">state</span> or federal <span class="dictionary">law</span>, by submitting an application for a license, the applicant shall be deemed to have appointed the clerk of the <span class="dictionary">Commission</span> as the agent for <span class="dictionary">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 <span class="dictionary">Commission</span> as agent for <span class="dictionary">service of process</span> shall be irrevocable during the period within which a <span class="dictionary">cause of action</span> against the applicant may arise out of transactions with respect to subjects of pharmacy benefits management in the Commonwealth. <span class="dictionary">Service of process</span> on the clerk of the <span class="dictionary">Commission</span> shall conform to the provisions of Chapter 8 (&#xA7; <a class="law" title="Definition" href="/38.2-800/">38.2-800</a> et seq.). <a id="paragraph-294251" class="section-permalink" href="https://vacode.org/38.2-3466/#E"><i class="fa fa-link"/></a></p></section>
						<section id="F"><p><span class="prefix-number">F.</span> Each applicant that has complied with the provisions of this article and <span class="dictionary">Commission</span> regulations is entitled to and shall receive a license in the form the <span class="dictionary">Commission</span> prescribes. <a id="paragraph-294252" class="section-permalink" href="https://vacode.org/38.2-3466/#F"><i class="fa fa-link"/></a></p></section>
						<section id="G"><p><span class="prefix-number">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 <span class="dictionary">Commission</span>. The fee shall be collected by the <span class="dictionary">Commission</span> and paid directly into the <span class="dictionary">state</span> treasury and credited to the &#x201C;<span class="dictionary">Bureau of Insurance</span> Special Fund &#x2014; <span class="dictionary">State</span> Corporation <span class="dictionary">Commission</span>&#x201D; for the maintenance of the <span class="dictionary">Bureau of Insurance</span> as provided in subsection B of &#xA7; <a class="law" title="Expense of administration of insurance laws borne by licensees; minimum contribution" href="/38.2-400/">38.2-400</a>. <a id="paragraph-294253" class="section-permalink" href="https://vacode.org/38.2-3466/#G"><i class="fa fa-link"/></a></p></section>
						<section id="H"><p><span class="prefix-number">H.</span> The <span class="dictionary">Commission</span> may refuse to <span class="dictionary">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 <span class="dictionary">Commission</span> regulations. <a id="paragraph-294254" class="section-permalink" href="https://vacode.org/38.2-3466/#H"><i class="fa fa-link"/></a></p></section>
						<section id="I"><p><span class="prefix-number">I.</span> A <span class="dictionary">person</span> that violates the provisions of this section may be subject to a civil <span class="dictionary">penalty</span> of $5,000 for each day on which such violation occurs. The <span class="dictionary">Commission</span> may adopt such rules or establish such guidelines as may be necessary to enforce the provisions of this section. <a id="paragraph-294255" class="section-permalink" href="https://vacode.org/38.2-3466/#I"><i class="fa fa-link"/></a></p></section></text><history>2020, cc. 219, 1288; 2024, cc. 329, 626.</history><metadata></metadata></law>
