Marcia Hultman

Cabinet Secretary

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Division of Insurance

Third Party Administrator/Pharmacy Benefits Manager

Third Party Administrators, including Pharmacy Benefits Managers (PBM), are required to submit license and/or registration applications using the Third Party Administrator Form available online through Sircon (Vertafore). In addition, all pertinent documents relating to the Application Checklist must be attached to the electronic application.

Contact the Division of Insurance with any questions regarding the application. If contacting by email, please enter TPA Application in the subject line.

Pharmacy Benefits Manager Listing

Third Party Administrator Listing

Contact the Division of Insurance