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Home » Bulletins » Illinois Announces New PBM Reporting and Fee Requirements for 2025

Illinois Announces New PBM Reporting and Fee Requirements for 2025

IL| The Illinois Department of Insurance Company Bulletin 2025-13 outlines new reporting and fee requirements for Pharmacy Benefit Managers (PBMs) under Public Act 104-0027. By August 1, 2025, each PBM registered in Illinois must submit a report listing every health benefit plan they administer and the number of covered individuals per plan using a specified reporting template. By September 1, 2025, each PBM must remit a fee of $15 per covered individual, submitting payment and a fee form, both requiring officer attestation.

Key Points:

  • PBMs must file covered individual counts for each administered health benefit plan by August 1, 2025.
  • PBMs must pay a $15 fee per covered individual, with payment due by September 1, 2025.
  • Compliance requires use of state-provided forms; payments and submissions go to the Illinois Department of Insurance.

Click here to see IL Company Bulletin 2025-13

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