Please Note: The SCDOI does not have regulatory authority over the following health plan types:
Out-of-State Plans Government Healthcare Programs (e.g., Medicaid, Medicare, TRICARE, Veterans Health Administration, Indian Health Services, Children’s Health Insurance Program and State Health Insurance)
I declare that the information I have provided is true and accurate to the best of my knowledge. This information will be
forwarded to the PBM (and/or other party that is the subject of your complaint) for the investigation of this matter. By submitting this form, I am authorizing the SC
Department of Insurance to pursue an investigation into my complaint and the party(ies) complained against to release
all relevant information, documents, and records to the SC Department of Insurance.
The information or data acquired during an examination or review is considered proprietary and confidential and is not subject to the South Carolina Freedom of Information Act, in accordance with Regulation 69-77.II.C. and Sections 38-71-2220(C), 38-71-2250 and 30-4-40 of the Code of Laws of South Carolina, 1976, as amended.
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