EBSA Releases Final Rule on PBM Fee Disclosure

• On November 2, 2026, the Employee Benefits Security Administration (EBSA) within the Department of Labor (DOL) published a final rule titled Improving Transparency into Pharmacy Benefit Manager Fee Disclosure (Final Rule).
• The Final Rule requires pharmacy benefit managers (PBMs) and their affiliated brokers and consultants to disclose their fees and compensation to large, employer-sponsored, self-insured group health plans, implementing requirements from the Consolidated Appropriations Act of 2026. The following information is subject to the disclosure requirements:
  • Rebates and other payments from drug manufacturers.
  • Compensation received when the price paid by the plan for a prescription drug exceeds the amount reimbursed to the pharmacy.
  • Payments recouped from pharmacies in connection with prescription drugs dispensed to plan participants.
• PBMs and their affiliated brokers and consultants must provide initial written disclosures before entering, extending, or renewing an arrangement.  
• PBMs and their affiliated brokers and consultants must report compensation actually received semiannually, or quarterly if the plan requests it.  
• Disclosures cover services, direct and indirect compensation, compensation allocations among affiliates/subcontractors, price-protection arrangements, and potential conflicts.
• Disclosures must be accessible and in plain language, state compensation as a monetary amount or good-faith estimate, and be available in a standard machine-readable format upon request.  
• A plan may audit the accuracy of PBM disclosures annually, select the auditor, and pay the auditor.  
• EBSA projects that the Final Rule will lower prescription drug costs for health plans and participants by as much as $22 billion over 10 years.
• The Final Rule is effective January 4, 2027 and applies to plan years beginning on or after July 1, 2027.

More on This Topic:

Final Rule

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