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PBM transparency rules fall short for brokers on pharmacy pricing
A proposed Department of Labor rule would require PBMs and certain advisors to disclose compensation, but it still would not let brokers tell plan sponsors what a prescription will cost at the pharmacy counter.
Benefits brokers are facing a gap between rising PBM disclosures and what plan sponsors need, according to an industry executive speaking to Insurance Business Benefits US. Raechele McMahan, senior vice president of Payer Solutions at Prescryptive Health, said PBMs can disclose intended rebates, but that does not necessarily give brokers or plan sponsors meaningful choice or control over how prescription costs play out at the pharmacy counter.
McMahan tied the problem to a new round of federal transparency efforts that regulators are tightening. On January 30, 2026, the Department of Labor issued a proposed rule requiring PBMs and affiliated brokers and consultants to disclose their compensation, including rebates, spread pricing, and administrative fees, to fiduciaries of self-insured group health plans subject to ERISA.
The proposal is designed to implement section 12 of President Trump’s Executive Order 14273 and would apply to plan years beginning on or after July 1, 2026, according to the report. The executive argued that even with these disclosures, brokers still cannot provide clients with direct, counter-level prescription pricing information.