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The Indiana Pharmacy Benefit Manager license

Pharmacy Benefit Manager

Runs the drug benefit for a health plan. Indiana grants it on a certification of licensure and asks for ten separate attachments, of which the audited accounts have to show a positive net worth.

Course

None

This license has no pre-licensing course route.

Ways in

1

There is no state exam for this license.

Exam

n/a

Not required on any of the routes below.

Every way to qualify

  1. Route 1 Apply electronically through Sircon

    No state exam for this license

    Audited accounts showing a positive net worth

    • Current audited annual financial statements prepared by an independent certified public accountant under generally accepted accounting principles and reflecting a positive net worth. It is the only financial test in the application and it is a floor rather than a figure.

    and who owns and runs it

    • Articles of incorporation or other organizing documents, the address of every Indiana office or a statement that there are none, every name the applicant has operated under in the last five years by jurisdiction including predecessors and known successors, a list of stockholders holding ten percent or more, investors holding ten percent or more, partners, officers, directors, trustees, members and affiliates with percentages, a chart of the relationship to all affiliates marking any that are insurance companies, and NAIC biographical affidavits for all of them.

    and a business plan and a client list

    • A statement describing staffing levels and activities proposed in Indiana and nationwide, and the applicant's capability to supply experienced people in pharmacy contracting, benefit administration, claims processing, formulary development, prior authorization, rebate administration, network building and record keeping. Plus every health plan it serves in Indiana with the date it started and the NAIC number of any insurer.

    and written appeals and pricing procedures

    • Copies of the written policies and procedures showing compliance with the appeals and dispute resolution process and the maximum allowable cost pricing requirements at IC 27-1-24.5-22, filed with State Form 57243, the Department's Pharmacy Benefit Manager Compliance Checklist.

    IC 27-1-24.5 and 760 IAC 5. The Department heads the requirements "Certification of Licensure" and takes the whole application electronically at Sircon. There is no examination, no course and no competence finding on any individual: what is examined is the entity's accounts, its ownership, its plan and its written procedures. It runs its own Pharmacy Benefit Manager Division with a compliance inbox, which no other Indiana license class has.

    Read at the Department on 2026-08-19

No national seller sells a course for this license, and nothing could. What Indiana examines is the entity's audited accounts, its ownership, its business plan and its written appeals and pricing procedures. There is no examination of any person and no course.