Pharmacy Benefit Managers

A pharmacy benefits manager performs pharmacy benefits management services for an entity offering pharmacy benefits to their customers. Pharmacy benefits manager does not include a health insurer licensed in the state if the health insurer or its subsidiary is providing pharmacy benefits management services exclusively to its own insureds, or a public self-funded pool or a private single employer self-funded plan that provides such benefits or services directly to its beneficiaries.

药企福利管理机构为提供药企福利给其客户的实体提供药企福利管理服务。若健康保险公司或其子公司仅向其自身投保人提供药企福利管理服务，或者为公共自筹资金池或私人单一雇主自筹计划提供此类福利或服务，则不属于州内获得许可的健康保险公司。