EBSA Proposed Regulation on Pharmacy Benefit Manager Fee Disclosure

What: On January 30, 2026, the Employee Benefits Security Administration (EBSA) published a proposed rule to require providers of pharmacy benefit management services and affiliated providers of brokerage and consulting services to disclose information about their compensation to fiduciaries of self-insured group health plans subject to the Employee Retirement Income Security Act (ERISA). The disclosure requirements would apply for purposes of ERISA’s statutory prohibited transaction exemption for service arrangements. If finalized, the proposed rule would affect sponsors and other fiduciaries of self-insured group health plans and certain service providers to such plans.

Why: EBSA requests comments on the following:

• The proposed definition of “Pharmacy Benefit Management Services”, as well as comments on whether the description of services should be altered or amended to include additional services.
• The proposed definitions of affiliate, agent, and subcontractor, including whether parties such as rebate aggregators or PBM-affiliated group purchasing organizations (GPOs) (or any other parties that fall within the proposed definition of agent) are likely to be covered by either of the other proposed definitions (i.e., affiliate or subcontractor).
• The proposed disclosure requirements, including but not limited to disclosures for direct compensation.
• The proposed requirement to explain how formulary incentives and arrangements affect services to and are aligned with the interests of the self-insured group health plan and/or its participants and beneficiaries.
• EBSA estimates and underlying assumptions of the benefits, costs, and transfers associated with the proposed rulemaking, as well as any quantifiable data that would support or contradict any aspect of its analysis, including economic impacts and impacted business entities. 

Action: Review and submit comments to EBSA on or before the March 31, 2026, deadline.

PROPOSED RULE:

Improving Transparency into Pharmacy Benefit Manager Fee Disclosure

CONTACT:

Will Purcell

EMAIL:

will.purcell@sba.gov

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