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Third Party Administrator and Pharmacy Benefit Manager Licensing and Compliance Developments

South Dakota - The South Dakota Division of Insurance (“Division”) recently took regulatory action against a TPA that has held a valid TPA registration in South Dakota since 2006.  In 2021, the TPA submitted its TPA...more

Louisiana Insurance Department Issues Cease and Desist Orders to a TPA and the Louisiana Office of Group Benefits for Failure to...

The Louisiana Insurance Department (“Department”) recently issued separate Cease and Desist Orders to both a TPA operating as a Pharmacy Benefit Manager (“PBM”) and the Office of Group Benefits, a Louisiana state agency that...more

Recent Regulatory Actions Against TPAs (UPDATED)

The Kansas Insurance Department (“Kansas Department”) recently issued a Summary Order against a Missouri-domiciled third party administrator (“Company”) revoking the Company’s Kansas non-resident TPA license....more

Third Party Administrator Newsletter - December 2019

Vermont Regulatory Action: A Reminder that Insurers Must Maintain Oversight of Their TPA and PBM Business Partners The Vermont Department of Financial Regulation (the “Department”) recently took significant enforcement...more

Vermont Regulatory Action: A Reminder that Insurers Must Maintain Oversight of their TPA and PBM Business Partners

The Vermont Department of Financial Regulation (the “Department”) recently took significant enforcement action against an insurer after determining that the insurer had violated various provisions of Vermont’s insurance laws,...more

National Association of Insurance Commissioners Considering Adoption of Pharmacy Benefit Manager Model Law

The Chair of the National Association of Insurance Commissioners (“NAIC”) Regulatory Framework (B) Task Force recently announced that the Pharmacy Benefit Manager Regulatory Issues (B) Subgroup’s (“PBM Subgroup”) will...more

Recent TPA Regulatory Developments

NEVADA: The Nevada Division of Insurance is in the process of adopting proposed insurance regulation R087-17 (the “Regulation”) which is entitled “Third Party Administrator Parental Guaranty and Notification Requirements.”...more

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