This bill amends the Pharmacy Benefits Manager (PBM) Regulation Act to introduce more stringent oversight and transparency for pharmacy benefits managers. The legislation defines key terms such as “bona fide service fee” as a flat dollar amount charged for pharmacy benefits management services that is consistent with fair market value, and introduces the concept of a “conflict of interest” where a PBM derives remuneration beyond a standard service fee. The bill requires PBMs to be licensed by the state superintendent of insurance and mandates annual license renewal, with provisions for license suspension or revocation if a PBM operates contrary to its application, fails to meet licensing requirements, has a conflict of interest, or does not comply with state or federal laws. Notably, the bill adds language that allows the superintendent to revoke a PBM’s license and requires the PBM to immediately conclude its affairs if found in violation. The legislation also explicitly states that a PBM’s failure to comply with the superintendent’s orders constitutes an unfair or deceptive trade practice, providing additional regulatory teeth to ensure compliance. While the bill does not allow PBMs to transact insurance business, it significantly expands the state’s ability to monitor and control PBM activities to protect pharmacies and consumers.