The Washington Health Care Benefit Manager license
Health Care Benefit Manager
Washington's answer to the pharmacy benefit manager license, and it is wider than the name most states use: one registration covers pharmacy, radiology, laboratory and mental health benefit management alike, and the test is whether the service affects patient access to care. $500 to register and $750 to renew since 2026-01-24.
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
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Route 1 Register with the commissioner and renew it every year
No state exam for this license
Who the applicant is
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An application verified by affidavit or declaration naming the manager, everybody with an ownership or controlling interest in it and every entity it controls, its business licenses and tax identification numbers, its areas of specialty, and its certificate of registration with the Washington Secretary of State
and the capacity to comply
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A finding that the applicant has committed no act that would result in denial, suspension or revocation, has paid the fees, and has the capacity to comply with state and federal law and has designated a person responsible for that compliance
RCW 48.200.030(1) requires the registration to conduct business here and to be renewed annually, and 48.200.030(2)(a)(iii) is where the breadth shows: the application asks for "any areas of specialty such as pharmacy benefit management, radiology benefit management, laboratory benefit management, mental health benefit management, or other specialty". The Office turns that into a functional test, listing prior authorization, certification of benefits, medical necessity decisions, utilization review, benefit decisions, claims processing and repricing, outcome management, payment authorization and appeals as services that trigger it. Subsection (2)(b) sets the fees by rule at a level that keeps the program self-supporting, and requires only one application however many carriers the manager contracts with; the Office raised the registration fee from $200 to $500 and the base renewal from $500 to $750 in a rule updated on 2025-12-24 and applying to registrations and renewals from 2026-01-24. Subsection (6) is a seven-year record retention duty on every transaction. From 2026-01-01 a self-funded group health plan may opt in to parts of the chapter, and a pharmacy benefit manager contracted exclusively with such a plan does not register at all, though it still owes the duties listed at RCW 48.200.330(2). There is no examination, no course and no experience requirement in any of it.
Read at app.leg.wa.gov on 2026-08-19
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No national seller sells a course for this license. The registration asks who owns the applicant and whether it can comply, and RCW 48.200.030 sets no examination and no education requirement at all.