Pharmacy Benefit Managers
As required by Utah Code § 31A-46-301 and Rule R590-282, every Pharmacy Benefit Manager (PBM) operating in the State of Utah is required to be licensed and submit an annual report. Below are two sets of links. To obtain an license, use the licensing links below.
For information on how to complete and file the annual PBM report, use the link for the Utah Pharmacy Benefit Manager Report.
Authority to license
- Utah Code 31A-46 — Pharmacy Benefit Manager Licensing Act
- Rule R590-282 — Pharmacy Benefit Manager Reporting
- Insurance Department Fee Schedule
Licensing forms
The licensing period for PBMs begins on April 1 each year and ends on March 31 of the following year.
Send Applications by email or postal mail to:
email company-renewals@utah.gov
or
Utah Insurance Department
Attn: Company Licensing
4315 S. 2700 W., Suite 2300
Taylorsville, UT 84129
Licensing questions should be directed to company-renewals@utah.gov.
Utah pharmacy benefit manager report
Pharmacy benefit manager list
Pharmacies may use this list to contact a PBM:
| PBM | Contact Name | Phone | |
|---|---|---|---|
| A & A Services LLC dba Sav-Rx Prescription Services | Ronda Thiessen | 402-753-2839 | gov@savrx.com |
| Alluma LLC | Lisa Hudspeth | 314-684-6568 | lmhudspeth@express-scripts.com |
| AmWINS Group Benefits | Pharmacy Network Management Team | 800-788-2949 | pharmacyoperationssups@medimpact.com |
| Capital Rx Inc. | Customer Care | 833-599-1020 | provider.relations@cap-rx.com |
| CarelonRx Inc. | Shawn Smith | 480-652-9980 | rxservices@cvshealth.com |
| Caremark LLC | Karen Llano | 480-314-8319 | rxservices@cvshealth.com or Karen.Llano@CVSHealth.com |
| Costco Health Solutions Inc. | Lisa Simpson | 425-313-6275 | lsimpson@costco.com |
| DST Pharmacy Solutions Inc. | Sharon McDonald | 973-600-9639 | NPharmacy@sscinc.com |
| Empirx Health LLC | Appeal Contact | 877-361-4338 | MAC@empirxhealth.com or jjordan@empirxhealth.com |
| Express Scripts Administrators LLC dba Express Scripts | Pharmacist Resource Center | 800-922-1557 | prc.express-scripts.com |
| FairosRx LLC | Aidan Tuite | 800-880-9988 | providerinfo@scriptcare.com or customerservice@scriptcare.com |
| Fairview Pharmacy Services LLC dba ClearScript | Pharmacy Network Management | 800-788-2949 | pharmacyoperationssups@medimpact.com |
| Healthcare Highways Rx LLC dba CerpassRx | Brittany Brodie | 972-830-2730 | Brittany.Brodie@CerpassRx.com |
| Humana Pharmacy Solutions Inc. | Pharmacy Audits | 502-580-3232 | pharmacyaudit@humana.com |
| Independent Health's Pharmacy Benefit Dimensions LLC | John Doyle/PBD Helpdesk | 716-635-7862 or 800-993-9898 | pbdcontracts@pbdrx.com or servicing@pbdrx.com |
| LucyRx Health Solutions Ohio LLC | Pharmacist Resource Center/Heather Dowdy | 800-922-1557 or 559-476-8000 | prc.express-scripts.com or hdowdy@lucyrx.com |
| MaxCare LLC | Colette Lamont/Julie Ezell/Doug Krause | 877-557-5707 or 877-557-5707 or 800-259-7765 | clamont@ppok.com or jezell@ppok.com or regulatoryaffairs@ppok.com |
| MaxorPlus, Ltd doing business as Vytlone | Michael Halling | 800-687-0707 or 806-639-7598 | macappeals@maxor.com or mdhalling@vytlone.com |
| MedImpact Healthcare Systems Inc. | MedImpact Pharmacy Network Management Team | 800-788-2949 | pharmacyoperationssups@medimpact.com |
| Navitus Health Solutions | Provider Services | 920-221-4100 or 608-298-5778 | auditing@navitus.com or pricingresearch@navitus.com |
| Northwind Rx Administration LLC | Steve Zetzel | 800-722-0772 | steve.zetzl@nwpharma.com or support@nwpharma.com or support@northwindhealth.com |
| OptumRx Inc. | Help Desk | 888-290-5416 or 888-445-8745 | orxdoilic@optum.com or provider.relations@optum.com |
| PerformRx LLC | Pharmacy Pricing | 800-555-5690 | performrxpharmacypricingdept@performrx.com |
| PharmaForce Group LLC | Patrick Stang | 313-466-6121 or 814-393-7355 or 833-379-1643 | pharmacynetwork@thepharmaforce.com or PStang@thepharmaforce.com |
| Phoenix Benefits Management LLC | Jonathan Yearty-MAC appeals; Katrina Schultz-pharmacy audits | 877-643-2067/866-249-3335 | jonathan.yearty@phoenixpbm.com or quality@phoenixpbm.com |
| Prescryptive Health Inc. | Pharmacy & Member Help Desk/Kelley Sanchez | 512-851-1853 or 425-655-2249 | pharmacyrelations@prescryptive.com or kelley@prescryptive.com |
| Prime Therapeutics Management LLC | Provider Relations | 888-277-5510 x1 | providerrelations@primetherapeutics.com |
| Prime Therapeutics LLC | Provider Relations | 888-277-5510 x1 | providerrelations@primetherapeutics.com |
| ProAct | Angela Plassmann | 413-265-1260 | aplassmann@rxsense.com |
| ProCare Pharmacy Benefit Manager | Call Center/Kim Foster | 800-377-1037 | network@procarerx.com or kfoster@procarerx.com |
| Progyny | Nilima M. Singh | 646-350-0747 | legal@progyny.com |
| RealRx LLC | Help Desk | 855-859-4892 | networks@coopbenefitsgroup.com or Drgriffel@coopbenefitsgroup.com |
| Rightway Healthcare Inc. | Anna Graffagnino | 888-665-1992 | pharmacynetwork@rightwayhealthcare.com |
| RxAdvance Corporation | Krupa Patel | 508-804-6900 or 877-281-1745 | krupa.patel@nirvanahealth.com or pharmacynetworkcontracting@rxadvance.com |
| Sagility LLC | Kim Schoonmaker | 720-598-7112 | Kim.schoonmaker@sagility.com |
| Script Care Ltd. | Pharmacy Help Desk | 800-880-9988 | providerinfo@scriptcare.com or customerservice@scriptcare.com |
| SelectHealth Benefit Assurance Co Inc. | Help Desk | 800-442-3127 | shpharmacycontracting@selecthealth.org |
| SelectHealth Inc. (PBM) | Help Desk | 800-442-3127 | shpharmacycontracting@selecthealth.org |
| Smith Health Inc. dba SmithRx | Liz Wannamaker | 844-512-3030 | pharmacynetwork@smithrx.com |
| Southern Scripts LLC dba Liviniti LLC | Robert Carney | 800-710-9341 | robert.carney@liviniti.com or legal@livinti.com |
| Towers Administrators LLC | Angela Plassmann | 413-265-1260 | aplassmann@rxsense.com |
| True Rx Management Services Inc. dba True Rx Health Strategists | Vicky Bohanon | 812-910-1394 | licensing@truerx.com |
| TrueScripts Management Services LLC | Alan Kaffenberger | 812-674-9711 or 844-257-1955 | alank@truescripts.com |
| Ventegra Inc. | Jenny Scruggs | 858-551-8111 x420 | network@ventegra.org or customercareteam@ventegra.org |
| WellDyneRx LLC | Tirthi Sheth | 888-479-2000 | administration@welldyne.com |
MAC pricing information
Maximum allowable cost (MAC) pricing information for each PBM active in Utah.
| Name of PBM | MAC Pricing |
|---|---|
| A & A Services LLC dba Sav-Rx Prescription Services | A&A Serivces utilizes MAC pricing via Medi-Span for AWP, via website at https://savrx.com/. MAC pricing is updated not less than every 7 days. This requires login via sav-rx and access will be provided. |
| Alluma LLC | Utilizes Express Scripts. Provider may request a MAC Pricing list through the online portal at https://prc.express-scripts.com; by contacting the pharmacy help desk via email at PBMProviderOperations@express-scripts.com; or by contacting the pharmacy resource center at 1-800-922-1557. |
| AmWINS Group Benefits LLC | AmWINS contracts with no pharmacies in Utah. |
| Capital Rx Inc. | Capital Rx, Inc., does not use MAC pricing. |
| CarelonRx Inc. | Access the Pharmacy Portal for CAREMARK LLC to obtain current MAC pricing at https://rxservices.cvscaremark.com/. MAC pricing also can be found online at caremark.com or submitting a MAC list request via email at MACInquiries@CVShealth.com. |
| CaremarkPhc LLC | CaremarkPhc no longer provides any pharmacy management services. |
| Caremark LLC | Access the Pharmacy Portal for CAREMARK LLC to obtain current MAC pricing at https://rxservices.cvscaremark.com/. MAC pricing also can be found online at caremark.com or submitting a MAC list request via email at MACInquiries@CVShealth.com. |
| CaremarkPCS Health LLC | Access the Pharmacy Portal for CAREMARK LLC to obtain current MAC pricing at https://rxservices.cvscaremark.com/. MAC pricing also can be found online at caremark.com or submitting a MAC list request via email at MACInquiries@CVShealth.com. |
| Change Healthcare Pharmacy Solutions Inc. | Surrendered License 3/20/2025. |
| Cigna Health and Life | Surrendered license 2/14/2025. |
| Costco Health Solutions Inc. | Costco Health Solutions does not use MAC pricing. |
| DST Pharmacy Solutions Inc. | DTS Pharmacy's MAC list pricing is available by contacting m5@dsthealth.com and at www.argushealth.com/myargus/MyArgus. |
| EmpirRX Health LLC | Utilizes Script Care. MAC Pricing list is available at www.scriptcare.com. Click on the "Pharmacy Portal" link in the upper right-hand corner and log into the portal or create an account if one does not exist. |
| Express Scripts Administrators LLC dba Express Scripts | Provider may request a MAC Pricing list through the online portal at https://prc.express-scripts.com; by contacting the pharmacy help desk via email at PBMProviderOperations@express-scripts.com; or by contacting the pharmacy resource center at 1-800-922-1557. |
| FairosRx LLC | Utilizes Script Care. Pharmacy may obtain the MAC Pricing list from the PBM's Pharmacy Portal located at www.scriptcare.com. |
| Fairview Pharmacy Services LLC dba ClearScripts | Utilizes Script Care. Pharmacy may obtain the MAC Pricing list from the PBM's Pharmacy Portal located at www.scriptcare.com, or by faxing 409-924-7825. |
| Healthcare Highways Rx LLC dba CerpassRx | Utilizes Script Care. Pharmacy may obtain the MAC Pricing list from the PBM's Pharmacy Portal located at www.scriptcare.com, or by faxing 409-924-7825. |
| Humana Pharmacy Solutions Inc. | Federal preemption applies. |
| Independent Health's Pharmacy Benefit Dimensions LLC | MAC Pricing list is updated at least every 7 calendar days and is available via the Provider Portal at https://www.pbdrx.com/pharmacy/portal. |
| LucyRx HealthSolutions Ohio LLC | Utilizes Express Scripts. Provider may request a MAC Pricing list through the online portal at https://prc.express-scripts.com; by contacting the pharmacy help desk via email at PBMProviderOperations@express-scripts.com; or by contacting the pharmacy resource center at 1-800-922-1557. |
| Magellan Rx Management | License inactivated on 5/21/2025. |
| MaxCare LLC | Pharmacy can access the MAC Pricing list at www.mc-rx.com and select the Participating Pharmacies options underneath the HealthCare Providers tab. |
| MaxorPlus Ltd. | MAC Pricing list is available by emailing macpricing@maxor.com or by phone at 800-687-0707. List will be provided within 1 business day. |
| MedImpact Healthcare Systems Inc. | Utilizes McKesson, Cardinal, and Amerisource Bergen for their MAC Pricing which is updated every 7 days and by emailing mac@medimpact.com. |
| Navitus Health Solutions LLC | MAC Pricing list is available at https://pharmacies.navitus.com/MAC. Changes are uploaded twice per week. |
| Northwind Rx Administration LLC | To access the MAC Pricing list, Provider may request the password from Ventegra’s Network Department by emailing Network@Ventegra.com. MAC pricing list will be provided within 1 business day. |
| OptumRx | MAC Pricing list is available online at https://www.optumrx.com. |
| PharmaForce Group LLC | Pharma Force does not utilize MAC pricing. |
| Phoenix Benefits Management LLC | Pharmacies can visit www.PhoenixPBM.com/Regulatory and download the most recent version of the MAC Pricing list. |
| Prescryptive Health Inc. | Prescryptive Health Inc., does not use MAC pricing. |
| Prime Therapeutics LLC | Pharmacy Access Requests are received through the Prime Provider Portal at: https://www.primetherapeutics.com/pharmacy-provider-tools. Access to MAC Pricing information will be provided to contracted Utah pharmacies within one business day. |
| Prime Therapeutics Management LLC | Pharmacy Access Requests are received through the Prime Provider Portal at: https://www.primetherapeutics.com/pharmacy-provider-tools. Access to MAC Pricing information will be provided to contracted Utah pharmacies within one business day. |
| ProAct Inc. | Contracts with Towers Administrators LLC dba RxSense. MAC Pricing list is updated by RxSense at least once per week. https://pharmacyportal.rxsense.com. |
| Procare Pharmacy Benefit | MAC Pricing list is available at https://mc-rx.com. |
| Progyny Inc. | Progyny, Inc., does not use MAC pricing. |
| RealRx LLC | ReallRx, LLC does not have any affiliated pharmacies. |
| ReformRx LLC | MAC Pricing list is available through the Pharmacy Portal at https://pharmacy.performrx.com. |
| Rightway Healthcare Inc. | MAC Pricing list will be provided within 1 business day upon a pharmacy's written request via email to pharmacynetwork@rightwayhealthcare.com. |
| Rx Bridge LLC | Surrendered License 10/9/2024. |
| RxAdvance Corp. | MAC Pricing list is available online at https://www.optumrx.com. |
| Sagility LLC | Sagility does not have a contract with a pharmacy. |
| Scrip World LLC | Scrip World does not perform traditional PBM services. |
| Script Care Ltd. | MAC Pricing List is available at https://scriptcare.com. Click on the "Pharmacy Portal" link in the upper right-hand corner and log into the portal or create an account if one does not exist. |
| SelectHealth Assurance Co. Inc. | MAC Pricing list is updated every 7 days. A MAC Pricing research request may be submitted through https://selecthealth.org/pharmacy/resources. |
| SelectHealth Inc. | MAC Pricing list is updated every 7 days. A MAC pricing research request may be submitted through https://selecthealth.org/pharmacy/resources. |
| Smith Health Inc. dba Smiths Rx | Pharmacy may receive MAC Pricing list by submitting a request through our online form at www.smithrx.com/pharmacies. The Pharmacy Network team will provide a response within 1 business day. |
| Southern Scripts LLC dba Livinti LLC | Utilizes Liviniti. MAC Pricing list readily available on the pharmacy provider website: https://liviniti.com/pharmacy-resources/. |
| Towers Administrators LLC | Utilizes RxSense. Pricing via Medispan. MAC Pricing list is updated by RxSense at least once a week. Pharmacy Portal is https://pharmacyportal.rxsense.com/pp. |
| True Rx Management Services Inc. dba True Rx Health | Utilizes RxSense. Pricing via Medispan; MAC Pricing list is updated by RxSense at least once a week. Pharmacy Portal is https://pharmacyportal.rxsense.com/pp. |
| TrueScripts Management Services | UtilizesOptumRx. MAC pricing is available at optumrx.com. |
| Ventegra Inc., a California Benefit Corporation | MAC Pricing list is available by requesting a password by emailing Ventegra’s Network Department at Network@Ventegra.com. Request is responded to within 1 business day. |
| VRx LLC | License relinquished 12/31/2024. |
| WellDyneRx LLC | Pharmacies can access the MAC Pricing list via welldyne.com. Special section for Utah pharmacies. |