Pharmacy Benefit Manager

INITIAL LICENSE

A complete application for Pharmacy Benefit Manager registration includes:

  1. FORM PBM  – one with original signature(s)
  2. Application fee $140. Make check payable to the Department of Commerce & Consumer Affairs.

IMPORTANT: All the items listed above must be submitted together as an application packet.  Incomplete applications will be returned to you.

LICENSE RENEWAL

Each Pharmacy Benefit Manager shall renew its registration by March 31 each year.  A complete application for Pharmacy Benefit Manager registration includes:

  1. FORM PBM  – one with original signature(s)
  2. Renewal Fee $140.  Make check payable to the Department of Commerce & Consumer Affairs.

Any late payment and/or submission of renewal application will result the inactivation of the registration.  Penalty fee $140 will be then assessed to reactivate the registration.

Visit the Hawaii State Legislature website at www.capitol.hawaii.gov and search and view the Hawaii Revised Statute.