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 [email protected]
or
Utah Insurance Department
Attn: Company Licensing
4315 S. 2700 W., Suite 2300
Taylorsville, UT 84129
Licensing questions should be directed to [email protected].
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 | [email protected] |
| Alluma LLC | Lisa Hudspeth | 314-684-6568 | [email protected] |
| AmWINS Group Benefits | Pharmacy Network Management Team | 800-788-2949 | [email protected] |
| Capital Rx Inc. | Customer Care | 833-599-1020 | [email protected] |
| CarelonRx Inc. | Shawn Smith | 480-652-9980 | [email protected] |
| Caremark LLC | Karen Llano | 480-314-8319 | [email protected] or [email protected] |
| Costco Health Solutions Inc. | Lisa Simpson | 425-313-6275 | [email protected] |
| DST Pharmacy Solutions Inc. | Sharon McDonald | 973-600-9639 | [email protected] |
| Empirx Health LLC | Appeal Contact | 877-361-4338 | [email protected] or [email protected] |
| Express Scripts Administrators LLC dba Express Scripts | Pharmacist Resource Center | 800-922-1557 | prc.express-scripts.com |
| FairosRx LLC | Aidan Tuite | 800-880-9988 | [email protected] or [email protected] |
| Fairview Pharmacy Services LLC dba ClearScript | Pharmacy Network Management | 800-788-2949 | [email protected] |
| Healthcare Highways Rx LLC dba CerpassRx | Brittany Brodie | 972-830-2730 | [email protected] |
| Humana Pharmacy Solutions Inc. | Pharmacy Audits | 502-580-3232 | [email protected] |
| Independent Health's Pharmacy Benefit Dimensions LLC | John Doyle/PBD Helpdesk | 716-635-7862 or 800-993-9898 | [email protected] or [email protected] |
| LucyRx Health Solutions Ohio LLC | Pharmacist Resource Center/Heather Dowdy | 800-922-1557 or 559-476-8000 | prc.express-scripts.com or [email protected] |
| MaxCare LLC | Colette Lamont/Julie Ezell/Doug Krause | 877-557-5707 or 877-557-5707 or 800-259-7765 | [email protected] or [email protected] or [email protected] |
| MaxorPlus, Ltd doing business as Vytlone | Michael Halling | 800-687-0707 or 806-639-7598 | [email protected] or [email protected] |
| MedImpact Healthcare Systems Inc. | MedImpact Pharmacy Network Management Team | 800-788-2949 | [email protected] |
| Navitus Health Solutions | Provider Services | 920-221-4100 or 608-298-5778 | [email protected] or [email protected] |
| Northwind Rx Administration LLC | Steve Zetzel | 800-722-0772 | [email protected] or [email protected] or [email protected] |
| OptumRx Inc. | Help Desk | 888-290-5416 or 888-445-8745 | [email protected] or [email protected] |
| PerformRx LLC | Pharmacy Pricing | 800-555-5690 | [email protected] |
| PharmaForce Group LLC | Patrick Stang | 313-466-6121 or 814-393-7355 or 833-379-1643 | [email protected] or [email protected] |
| Phoenix Benefits Management LLC | Jonathan Yearty-MAC appeals; Katrina Schultz-pharmacy audits | 877-643-2067/866-249-3335 | [email protected] or [email protected] |
| Prescryptive Health Inc. | Pharmacy & Member Help Desk/Kelley Sanchez | 512-851-1853 or 425-655-2249 | [email protected] or [email protected] |
| Prime Therapeutics Management LLC | Provider Relations | 888-277-5510 x1 | [email protected] |
| Prime Therapeutics LLC | Provider Relations | 888-277-5510 x1 | [email protected] |
| ProAct | Angela Plassmann | 413-265-1260 | [email protected] |
| ProCare Pharmacy Benefit Manager | Call Center/Kim Foster | 800-377-1037 | [email protected] or [email protected] |
| Progyny | Nilima M. Singh | 646-350-0747 | [email protected] |
| RealRx LLC | Help Desk | 855-859-4892 | [email protected] or [email protected] |
| Rightway Healthcare Inc. | Anna Graffagnino | 888-665-1992 | [email protected] |
| RxAdvance Corporation | Krupa Patel | 508-804-6900 or 877-281-1745 | [email protected] or [email protected] |
| Sagility LLC | Kim Schoonmaker | 720-598-7112 | [email protected] |
| Script Care Ltd. | Pharmacy Help Desk | 800-880-9988 | [email protected] or [email protected] |
| SelectHealth Benefit Assurance Co Inc. | Help Desk | 800-442-3127 | [email protected] |
| SelectHealth Inc. (PBM) | Help Desk | 800-442-3127 | [email protected] |
| Smith Health Inc. dba SmithRx | Liz Wannamaker | 844-512-3030 | [email protected] |
| Southern Scripts LLC dba Liviniti LLC | Robert Carney | 800-710-9341 | [email protected] or [email protected] |
| Towers Administrators LLC | Angela Plassmann | 413-265-1260 | [email protected] |
| True Rx Management Services Inc. dba True Rx Health Strategists | Vicky Bohanon | 812-910-1394 | [email protected] |
| TrueScripts Management Services LLC | Alan Kaffenberger | 812-674-9711 or 844-257-1955 | [email protected] |
| Ventegra Inc. | Jenny Scruggs | 858-551-8111 x420 | [email protected] or [email protected] |
| WellDyneRx LLC | Tirthi Sheth | 888-479-2000 | [email protected] |
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 [email protected]; 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 [email protected]. |
| 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 [email protected]. |
| 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 [email protected]. |
| 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 [email protected] 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 [email protected]; 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 [email protected]; 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 [email protected] 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 [email protected]. |
| 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 [email protected]. 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 [email protected]. |
| 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 [email protected]. 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. |