Pharmacy Benefit Manager

According to O.C.G.A. 33-64-1, a Pharmacy Benefit Manager means a person, business entity, or other entity that performs pharmacy benefit management which is the administration of a plan or program that pays for, reimburses, and coves the cost of drugs, devices, or pharmacy care to insureds on behalf of a health plan. This does not include the practice of pharmacy as defined in O.C.G.A. 26-4-4.

 

State of Georgia Recent Filing Changes             

Contact

Sircon Website to Apply, Renew and Update Licenses

Sircon.com/Georgia

As of January 24, 2025, Pharmacy Benefit Manager licensing is moving to Sircon.com/georgia. All applications and renewals are to be filed in Sircon.com. Initial applications and the renewal processes are detailed below along with links to forms and resources. 

  • Filing Fees

    Filing fee for initial license is $2,000.00 plus $5.00 processing fee

  • Prepare Information and Gather Documents and Forms

    The processing staff requests that all documents and forms be uploaded as one pdf. Scrolling through one document is preferred over downloading one document at a time. 

    Be prepared to enter all entity information such as name, EIN, responsible parties, business and mailing addresses along with phone numbers and email addresses

    Documents and Forms required to be uploaded with application:

    • Documents and Forms to prepare and gather prior to submitting the online application:
      • Bond in the amount of $100,000 in favor of the Commissioner executed by a corporate surety insurer authorized to transact business in Georgia (OCI provides a bond form if needed. Link is below in Forms)
        • Language must be included that the insurer may cancel the insurance upon 30 days advance notice filed with the Commissioner
        • Must be retained for at least one year if license is inactivated for any reason
      • Errors & Omissions Coverage in the amount of $250,000 written by an insurer authorized to transact business in Georgia
        • Coverage must be for a term of at least one year
        • Language must be included that the insurer may cancel the insurance upon 60 days advance notice filed with the Commissioner
        • Must be retained for at least one year if license is inactivated for any reason
      • Audited Financial statement or other such information that demonstrates the applicant possesses a minimum net worth of $200,000 (OCI provides a Financial Statement template if needed. Link is below in Forms)
      • Pharmacy Benefits Manager Notice of Affiliation (GID-283-NT - link provided below)
      • Citizenship Affidavit and ID, also known as Illegal Immigration Reform and Enforcement Act Form with copies of acceptable identification (Link to form and instructions below)

     

  • Renewals and Timelines

    Renewals are to be filed by May 1 of every year. A per day late fee of $15 will be imposed from May 2 through June 30. If not renewed or the renewal filing is not completed by June 30th, the license will be inactivated for reason of failure to renew. The company will be required to reapply.

    Following are the required items to filed in www.Sircon.com/georgia

    • Renewal fee of $1,000.00 plus $5.00 processing fee
    • Proof of Continuation of Bond in the amount of $100,000 in favor of the Commissioner executed by a corporate surety insurer authorized to transact business in Georgia
      • Language must be included that the insurer may cancel the insurance upon 30 days advance notice filed with the Commissioner
      • Must be retained for at least one year if license is inactivated for any reason
    • Errors & Omissions Coverage in the amount of $250,000 written by an insurer authorized to transact business in Georgia
      • Coverage must be for a term of at least one year
      • Language must be included that the insurer may cancel the insurance upon 60 days advance notice filed with the Commissioner
      • Must be retained for at least one year if license is inactivated for any reason
    • Audited Financial statement or other such information that demonstrates the applicant possesses a minimum net worth of $200,000
    • Citizenship Affidavit and ID is only required for a renewal if the previously filed individual is a non-citizen or if the officer, owner, partner or director is new to the organization

     

  • What to Expect After Filing Initial Application or Renewal
    • After submission, an email will be sent confirming submittal.
    • The application will be reviewed within ten (10) business days of submittal
    • Any deficiencies will be sent via an email to the applicant email address
    • All deficiencies must be resolved within 60 days of the email notice
      • If not completed, the application will be closed incomplete
      • Another application submittal including payment of all fees will be required. No refunds for closed incomplete applications.
    • If the application is approved, the license will be sent via email as an attachment. Please save the license. Any future copies will require a fee for printing.
  • Forms

    Forms:

  • Other Entity Update Filings

    More information to come for the following. If you need immediate information, please email [email protected].

    • Name Change after Licensed - Form to include SOS, By-laws and organization changes 
    • Address Changes after Licensed - addresses can be updated at www.sircon.com/georgia
    • Surrender of License
    • Change of Officers, Owners, Partners and Directors - email to [email protected]. Please provide license number and describe update and provide all necessary documents required.
    • Changes in By-laws or Organizational Structure - email to [email protected]. Please provide license number and describe update along with all documents. 
  • Resources