The Wisconsin Pharmacy Benefit Manager license
Pharmacy Benefit Manager
Administers or manages prescription drug benefits for an insurer or another payer without collecting premium or touching claims. A manager that does touch them takes the employee benefit plan administrator license instead, and the statute says so rather than leaving it to be worked out.
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 Post the bond and apply
No state exam for this license
The bond
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A performance bond meeting the specifications the commissioner sets under s. Ins 8.28, signed and sealed and sent to the Office in original, with a replacement required on a name, domicile or carrier change or on cancellation.
and the financial statement
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Financial statements for the most recently completed fiscal year in the applicant's own name, deconsolidated from any parent, not marked confidential and not required to be audited.
and the home state license, for a nonresident
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a reciprocal pharmacy benefit manager license in the resident state, which the Office requires before an entity may apply electronically; an entity without one applies on paper
s. 633.13(1) requires the license and s. 632.865(1)(c) is the definition it rests on: an entity doing business in this state that contracts to administer or manage prescription drug benefits on behalf of an insurer, a cooperative under s. 185.01(2), or another entity that provides prescription drug benefits to Wisconsin residents. The Office draws the line between this license and the administrator's by what the manager does with the money: "If the PBM solicits or collects premiums, effects coverage, or settles claims the entity must obtain an EBPA firm license."No examination, no course and no individual qualification: everything the subchapter asks about is the company. 633.13(3) puts the matching duty on the payer, which may not use an unlicensed manager.
Read at docs.legis.wisconsin.gov on 2026-08-19
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The Wisconsin products sellers do carry are all for a major producer line or for the adjuster paper; Aceable sells nothing in Wisconsin at all. Wisconsin asks for no course here and its examination vendor publishes no paper for this license, so there is nothing to sell.