Pharmacy Benefit Managers (PBMs)

Initial Application

Electronic Submission 

1. All initial applications and $1000 initial fee, must be submitted electronically via NIPR.com. (The SCDOI is no longer accepting paper applications)
2. *The required PBM States Specific Requirements- Initial License Application, in addition to the NIPR Uniform Application, can also be found on NIPR State Specific Requirements page.
3. All supporting documentation can be uploaded and submitted via the NIPR Attachment Warehouse or emailed directly to the Office of PBM Oversight at PBMDept@doi.sc.gov
4. You may follow this step-by-step guide to complete electronic application via NIPR.

* The PBM States Specific Requirements- Initial License Application MUST be submitted in addition to the NIPR application or your application may be delayed or denied.

License Renewal 

The renewal period is December 1 through February 15 and repeats annually. Pharmacy Benefit Managers that have not renewed their license by March 1^st will be subject to an initial license fee and may be subject to administrative action for any period of time for which the PBM license is not active. 

Electronic Submission: 

1. All renewal applications and $500 renewal fee must be submitted via NIPR.com. (The SCDOI is no longer accepting paper applications).
2. Submit all supporting documentation and PBM State Specific Requirements- License Renewal Application via NIPR's Attachment Warehouse or email directly to the Office of PBM Oversight at PBMDept@doi.sc.gov 

Additional Forms

• PBM Application Requirements Checklist
• PBM Electronic Application Guide
• PBM License Surrender Form
• PBM Change of Information Form

PBM Complaint Process

South Carolina law requires pharmacies to make all reasonable efforts to exhaust a PBM's internal appeal's process or work through their Pharmacy Services Administration Organization (PSAO) prior to submitting unresolved complaints to the South Carolina Department of Insurance (SCDOI). If all efforts have been made to resolve a potential violation, you may follow the steps below to file a complaint with the SCDOI.

To complete the PBM Complaint Form follow the steps below:

Submit via SCDOI Website:

1. Click PBM Complaint Form
2. Complete online form
3. Upload supporting documents directly to online form
4. Click "Submit" when complete

Submit via email:

1. Save PBM Complaint Form as a digital PDF document.
2. Complete fillable complaint form that was saved as digital PDF document. 
3. Email completed PBM Complaint Form and any supporting documents to the Office of PBM Oversight at PBMDept@doi.sc.gov..

Submit via fax:

1. Complete fillable PBM Complaint Form.
2. Print completed PBM Complaint Form.
3. Fax completed form and any supporting documents to the Office of PBM Oversight at (803) 737-1605.

Submit via mail:

1. Complete fillable PBM Complaint Form.
2. Print completed PBM Complaint Form.
3. Mail completed form and any supporting documents to 

Attn: Office of PBM Oversight
South Carolina Department of Insurance
1201 Main Street, Suite 1000
Columbia, SC 29201