Insurance Licensing

The renewal application is available on Sircon’s website beginning 90 days prior to your license expiration date. In order to ensure a timely license renewal, we recommend submitting the renewal application at least 75 days prior to your license expiration date.

In order to assist you in preparing to enter your license application or renewal, we have summarized the items you will need to furnish on the application. You may also view a video tutorial, demonstrating the use of the Sircon online PBM application.

NOTE: Sircon charges a small Transaction Fee for each application or renewal submitted. Sircon also charges a larger Processing Fee to users who have not created an account with Sircon. Create a Sircon for Agencies account with Sircon (and thus avoid the larger Processing Fee).

Please note that most PBM’s are currently required to be licensed as Third Party Administrators (TPAs) in the state of Minnesota. The new PBM licensing requirement does not replace the TPA licensing requirement; Most PBMs are required to hold both licenses on and after January 1, 2020.

Network Adequacy

Under Minnesota Statutes 62W.05, pharmacy benefit managers must provide an adequate and accessible pharmacy network that meets the relevant requirements of section 62K.10.

The Minnesota Department of Health (MDH) evaluates all provider networks submitted by applicants for PBM licensure and renewal. Email pbm.licensing@state.mn.us to initiate the network adequacy review.

Due Date for Initial Network Adequacy Reports and Renewals

For timely processing, start the network adequacy review process 90 days prior to the requested licensed effective date. Requests made less than 30 days prior to license effective date may be delayed.

Network Adequacy Report

Submit the following documents for each network as part of the initial license or renewal application. NOTE: clicking on links below results in the Excel or Word document opening in a new tab or the document may be directly sent to your "download" folder.

• Network Template (.xlsx) See instructions below
• Provider File Template (.xlsx)
• Network Adequacy Attestation (.docx)
• Geographic Access Maps (created by applicant):
  • A map identifying all counties in the network service area (Please do not plot pharmacy locations on this map. Label all counties.)
  • A map identifying in network retail pharmacy locations measured against the service area using the lesser of 60-mile/60-minute standard. Please use miles or minutes for the measurement and not radius.
  • A map identifying in network long term care pharmacies.
  • A map identifying in network specialty pharmacies.
  • A map identifying in network tribal pharmacies.
  • A map identifying in network home infusion pharmacies.
  • A map identifying in network mail order pharmacies.
  • Network Adequacy Waiver Request (.xlsm): required if retail pharmacy access does not meet the lesser of 60-mile/60-minute standard. Approved waiver requests automatically expire after three years. Waiver requests do not require annual renewal unless there are changes.

  The submission of these documents constitutes the Network Adequacy Report for PBM license applications and renewals.

  Initiating the Network Adequacy Review Process

  To initiate the network adequacy review and renewal processes, submit an email to PBM.Licensing@state.mn.us. Use the subject line, “MN PBM License – Network Adequacy.” This email must include the following information:

  • PBM Corporate Entity name.
  • PBM Federal Employer Identification Number (FEIN).
  • The total number of networks to be submitted under the license application.
  • A name for each network.
  • Primary contact name, phone number and email address.

  Using this information, MDH will provide a network template for each PBM license network, with a unique network identification number. Please note, new network identification numbers issued for each PBM renewal cycle. Via secure email, MDH will provide the partially completed network template and instructions to the primary contact.

  Please do not complete the PBM Network template until you receive the partially completed form with unique PBM network ID(s) assigned by MDH.

  Questions:

  Please direct Licensing questions to: PBM.Licensing@state.mn.us

  • purchases liability insurance on a group basis
  • purchases the insurance only for its group members just to cover their similar or related liability exposure
  • is composed of members whose businesses or activities are similar or related
  • is domiciled in a state

  All the requirements governing purchasing groups are found in Minnesota Statute Chapter 60E.

  Any insurance program marketed to purchasing groups in Minnesota must meet all the requirements found in state statutes and administrative rules that apply to liability insurance. It must also meet all the filing requirements for the line of coverage.

  The Purchasing Group itself must register with the Minnesota Department of Commerce using this application.

  General Information

  Each provider of service contracts sold in Minnesota must file a registration with the Department of Commerce. The registration fee is $750 annually. The statutes covering Service Contract Providers are found in M.S. 59B. All the information needed for registration is available in this file. Guarantee of Payment (.doc)

  Information About Bonding

  The Third Party Administrator Unit licenses third party administrators as defined by Minnesota Statutes 60A.23, Subdivision 8. Licenses are granted when the Commissioner of Commerce is satisfied that the administrator is capable of providing TPA services, is financially solvent and (if applicable) is able to process claims in a prompt and equitable manner. See Minnesota Statutes: 60A.23, Subdivision 8 and Minnesota Rules: Chapter 2767

  Licensing Forms

  • Application/Renewal form(.pdf)
    • Must be completed to be considered for TPA licensing or the renewal of a TPA license
    • Must be completed when applying for a TPA license when an applicant uses the financial statements of a parent or other related entity to meet the financial requirements. The guarantee must be accompanied by a resolution by the guarantor's board of directors authorizing the guarantee.

    License Reporting Requirements

    (Minnesota Rules: 2767.0700)

    Subp. 3 Report compliance. Each licensee shall file or ensure that the clients it services file all required reports relating to those services which the administrator provides within the times established by statute, rule, or order of the commissioner. Required reports include an annual activity report, filed within 60 days of the end of the calendar year, stating:

    1. the name and address of clients administered by the licensee in Minnesota during the previous calendar year;
    2. the area and type of service provided to each plan;
    3. the starting and/or termination date each client was serviced;
    4. the total number and total amount of claims paid and loss payments disbursed on behalf of each client; and
    5. the reserves established for each client.

    The annual activity report should be filed on the Excel spreadsheet form. The spreadsheet should be emailed to: tuan.tran@state.mn.us

    Contact
    Tuan Tran, Self-Insurance Analyst
    Minnesota Department of Commerce
    Email: tuan.tran@state.mn.us
    Phone: 651-539-1748
    Fax: 651-539-1550

    The statutes covering UROs are found in M.S. 62M. The URO Application Package (.pdf) contains all the forms and information you will need and also a copy of the Medical Necessity Evaluation Review Annual Report.

    Contact

    General Information

    • Vehicle Protection Product Warrantor Application (.pdf)
    • Guarantee of Payment (.doc)

    For questions on the Vehicle Protection Product Warrantors Application, you can write or call:

    Marie Douglas, Insurance Division-Workers’ Compensation Self-Insurance
    Minnesota Department of Commerce
    E-Mail: marie.douglas@state.mn.us
    Phone: 651-539-1743
    Fax: 651-539-1550

    Contact

    Tuan Tran, Self-Insurance Analyst
    Email: tuan.tran@state.mn.us
    Phone: 651-539-1748
    Fax: 651-539-1550
    • Broker Application - Business Entity (.pdf)
    • Broker Exemption (.pdf)
    • Broker Renewal - Business Entity (.pdf)
    • Individual Broker Application (.pdf)
    • Individual Broker - Renewal (.pdf)
    • Provider Application (.pdf)
    • Provider Renewal (.pdf)
    • Viatical Settlement Annual Statement (.pdf)

    Viatical FAQ

    Does Minnesota consider life settlements and viatical settlements to be the same for licensing purposes? Are “senior life settlements” outside the scope of the licensing law?
    Life settlements and viatical settlements are the same for licensing purposes, as are “senior life settlements” and the like. In enacting and modifying the Viatical Settlements Model Act of the National Association of Insurance Commissioners, Minnesota defined the business of viatical settlements to include any method of offering, soliciting, negotiating, or acquiring an interest in a life insurance policy by means of a viatical settlement contract, whether referred to as “life settlement,” “viatical settlement”, or any other term.

    Are there new license application forms for Viatical Settlement Brokers and Providers?
    Yes, applicants should use the 2011 forms that are available on the Department of Commerce Insurance website.
    

    How frequently must a viatical settlement provider, broker, or investment agent license be renewed?
    Annual

    What is the initial cost of a viatical settlement provider, broker, or investment agent license?
    $750

    How should viatical settlement contract forms or disclosure statement forms be submitted?
    Eventually we will require viatical settlement contract forms and disclosure statement forms to be submitted via SERFF. Until then, they should be submitted either (1) by e-mail (attached as a PDF file) to insurance.commerce@state.mn.us, with “Viatical Settlement Form Submission” as the subject: (2) by fax to 651-539-1550, with “ATTN: Viatical Settlement Form Submission” on the cover page; or 3) by mail to Minnesota Department of Commerce, ATTN: Viatical Settlement Form Submission, 85-7th Place East, Suite 500, St. Paul, MN 55101.

    If a company becomes license as a viatical settlement broker, is an individual agent at that company required to be licensed a as a viatical settlement broker as well?
    No. A license issued to a legal entity authorizes all partners, officers, members, and designated employees to act as viatical settlement brokers under the license. All individuals to be covered by the license, however, must be listed on the license application or in a subsequent supplement to it, and a biographical statement (as provided with application or in a supplement to it) must be submitted for each individual to be covered by the license.

    Does a bond need to be secured by the time of application?
    By the time of application, a viatical settlement provider or a viatical settlement broker must demonstrate evidence of financial responsibility through either (1) a surety bond using the State of Minnesota Viatical Settlement Broker or Provider Surety Bond form or (2) evidence of the existence of a deposit of cash, certificates of deposit, or securities or any combination thereof in the amount of $250,000. We accept proof of the cash, certificates or securities that have been filed in another state where the applicant is licensed as a viatical settlement provider or broker or provider.

    What is the renewal cost for a viatical settlement provider, broker, or investment agent license?
    $250

    Does E & O coverage of at least $250,000 meet the financial responsibility requirement?
    No

    Is there a financial responsibility requirement for viatical settlement providers and brokers?
    By the time of application, a viatical settlement provider or a viatical settlement broker must demonstrate evidence of financial responsibility through either (1) a surety bond using the State of Minnesota Viatical Settlement Broker or Provider Surety Bond form or (2) evidence of the existence of a deposit of cash, certificates of deposit, or securities or any combination thereof in the amount of $250,000. We accept proof of the cash, certificates or securities that have been filed in another state where the applicant is licensed as a viatical settlement provider or broker or provider.

    Is an insurance producer with the life line of authority who is operating as a viatical settlement broker under the exemption from licensing requirements required to post a bond?
    No

    Will the Department of Commerce accept NAIC biographical affidavits for officers/directors?
    Yes

    Must we submit a copy of a driver’s license for all officers/directors?
    No

    What is the process to add an individual to a business entity license once that license is issued? What is the process if an individual must be deleted from a business entity license mid-year? Is there a cost associated with adding or deleting an individual to a business entity license?
    A licensed viatical settlement provider, broker, or investment agent business entity must provide to the Department of Commerce new or revised information about officers, ten percent or more stockholders, partners, directors, members, or designated employees within 30 days of the change. There is no associated fee.

    According to the law, an insurance producer with the life line of authority is permitted to operate as viatical settlement broker, as long as the requirements for an exemption are met and the proper form is filed. Does this include a nonresident insurance producer with the life line of authority?
    Yes

    Does the broker exemption apply to agencies?
    No, only individual producers.

    In order to operate as a viatical settlement broker without a separate license, does an insurance producer with the life line of authority need to be licensed as such in Minnesota for at least one year, or is it sufficient to have been a licensed insurance producer in another state for at least one year and licensed as a producer in Minnesota?
    The producer must be currently licensed in Minnesota with the life line of authority and must have been so licensed in Minnesota in good standing for at least one year. Place note that Minnesota did not adopt the corresponding NAIC Model Act language for this provision.

    An insurance producer with the life line of authority is permitted to operate as a viatical settlement broker as long as the requirement for an exemption are met and the proper form is filed. Does this exemption expire?
    No, as long as the producer remains active and in good standing.

    Will I receive an exemption certificate?
    No. You will receive an e-mail from our department stating that the exemption has been granted.