Pharmacy Benefit Manager

Effective January 1, 2022, penalty fee, reinstatement term, CE term and certain licensing requirements will be changed and implemented, please refer to Commissioner’s Memorandum 2021 – 9LIC for more information.

Effective November 15, 2022, new changes and mandatory requirements for individuals and business entities due to the transition to NAIC’s State Based System (SBS), please refer to Commissioner’s Memorandum 2022-10LIC.

INITIAL REGISTRATION

For initial or if you held a HI Pharmacy Benefit Manager registration that was inactive for more than one year.

Before submitting your online application:

An individual resident applicant must first obtain fingerprints, schedule an appointment online at https://www.fieldprinthawaii.com. Effective September 1, 2018, all applicants must enter the code “HI-DCCA-INS” that identifies the Insurance Division as the intended recipient of your fingerprint result, when scheduling an online appointment with Fieldprint.

To apply electronically:

  1. Go to http://nipr.com/(Use NIPR’s “Apply for a New License” online application).
  2. Must submit Form DP for PBM via NIPR’s Attachments Warehouse (within 7 days from the date the application is submitted). Form DP for PBM can be obtained at https://cca.hawaii.gov/ins/producers/forms/.

IMPORTANT: The Form DP for PBM is required to be attached to the NIPR’s attachment Warehouse within 7 days of submitting the application.   Your application may be considered “rejected” if Licensing Branch does not receive the document(s) within 7 days from the date the application is submitted. No refund if application is rejected.

RENEWAL OR LATE RENEWAL (Late Renewal means if you held a HI Pharmacy Benefit Manager registration that has been inactivated within one year of expiration).

Each Pharmacy Benefit Manager shall renew its registration by March 31 each year.

Apply electronically and pay renewal or renewal late fees at http://nipr.com/ (Use NIPR’s “Renew an Existing License” online application).

REINSTATEMENT (Reinstatement means if you held a HI Pharmacy Benefit Manager registration that has been inactivated for more than one year).

You will apply as a new applicant for initial registration.  Follow the same instructions and requirements in the beginning of the page to apply for the initial individual (Initial) or the business entity (initial) Pharmacy Benefit Manager registration via http://nipr.com (Use NIPR’s “Apply for a New License” online application).

For more information on pharmacy benefit manager registration, refer to the Hawaii Revised Statutes: §431S