2026-22306·DEPARTMENT OF LABOR

Improving Transparency Into Pharmacy Benefit Manager Fee Disclosure

Final RuleFinal Rule

Published: Nov 2, 2026
Effective: Jan 4, 2027
Citation: 91 FR 69092
Agencies: DEPARTMENT OF LABOR, Employee Benefits Security Administration

Final rule.

Summary

The U.S. Department of Labor has issued a final rule that obligates pharmacy‑benefit managers (PBMs) and any brokerage or consulting firms tied to them to reveal how they are paid to the fiduciaries of large, self‑insured group health plans covered by ERISA. The goal is to give plan sponsors clear information about both direct and indirect compensation so they can judge whether the fees and contract terms are reasonable, a step the agency says will help curb the rapid rise in pharmacy spending that drives overall health‑care costs for employers. The rule applies to two groups: (1) the fiduciaries—typically the employers or their designated administrators—who oversee large self‑insured health plans, and (2) the PBMs, brokers and consultants that provide pharmacy‑benefit services to those plans. By requiring these disclosures, the Department hopes to increase transparency in line with President Trump’s Executive Order 14273, which calls for measures to lower drug prices. The regulation was published in the Federal Register on November 2, 2026 (91 FR 69092) and becomes effective on January 4, 2027. Because it is a final rule, the public comment period has already closed. Starting on the effective date, PBMs and related service providers must submit the required compensation information to plan fiduciaries, and the Department of Labor will oversee compliance and may issue guidance or enforcement actions as needed.

AI-generated summary — verify against the Federal Register text.

Official abstract

The Department is issuing a final regulation that will require providers of pharmacy benefit management services and affiliated providers of brokerage and consulting services to disclose information about their compensation to fiduciaries of large, self-insured group health plans subject to the Employee Retirement Income Security Act (ERISA). Pharmacy spending is a major driver of overall healthcare costs for employers and is growing faster than medical and surgical spending. These disclosure requirements apply for purposes of ERISA's statutory prohibited transaction exemption for service arrangements under section 408(b)(2). These disclosures are needed so that fiduciaries can assess the reasonableness of contracts or arrangements with these service providers, including the reasonableness of the service providers' compensation. As directed in section 12 of President Trump's Executive Order 14273, Lowering Drug Prices by Once Again Putting Americans First, the Department is issuing this rule to improve employer health plan transparency into the direct and indirect compensation received by pharmacy benefit managers. This final rule will affect sponsors and other fiduciaries of large, self-insured group health plans and certain service providers to such plans.