Compliance Briefing | April

DOL Extends Comment Period on Proposed PBM Fee Disclosure Rule

The Department of Labor (DOL) has announced a short extension to the comment period for its proposed rule on pharmacy benefit manager (PBM) compensation transparency. The rule is intended to strengthen disclosure requirements for PBMs and related service providers working with self-insured group health plans subject to ERISA.

Employers and other stakeholders now have until April 15, 2026, to submit comments, an additional 15 days beyond the original March 31 deadline.

The extension follows the passage of the Consolidated Appropriations Act, 2026 (CAA, 2026), which includes new statutory requirements affecting PBMs and plan transparency. The DOL asks stakeholders to comment on whether the rule should be revised to align with new statutory requirements, whether additional provisions are needed and how to minimize administrative complexity while maintaining transparency goals.

For sponsors of self-insured health plans, this rule represents a continued shift toward greater fiduciary responsibility and visibility into vendor compensation.

Why This Rule Matters

PBMs play a central role in managing prescription drug benefits for employer-sponsored health plans. In recent years, they have gained increased influence over drug pricing, rebate arrangements, and formulary decisions.

The proposed rule stems from a presidential directive aimed at:

• Increasing visibility into PBM compensation structures
• Reducing prescription drug costs
• Promoting accountability in the healthcare supply chain

Employers have much to gain, including improved insight into how PBMs are paid, better tools to evaluate contract terms and increased leverage in negotiating pharmacy benefit arrangements

At the same time, the changes may introduce additional administrative oversight responsibilities and greater scrutiny of plan fiduciary decisions.

Key Provisions of the Proposed Rule

If finalized, the rule would impose new disclosure obligations on PBMs and the brokers and consultants that use PBM services.

Service providers would need to disclose:

• Direct compensation received from the plan
• Indirect compensation, including payments from third parties
• Expected future compensation (advanced estimates)

These disclosures are intended to help plan fiduciaries evaluate whether service arrangements and associated fees are reasonable under ERISA’s prohibited transaction rules.

The proposal also includes audit provisions, allowing plan fiduciaries to verify the accuracy of disclosed compensation and whether compensation aligns with contractual terms. The aim is to give employers more practical oversight of PBM arrangements.

The CAA, 2026 introduces several statutory changes that directly affect PBM transparency and oversight:

• The law amends ERISA Section 408(b)(2) to require additional reporting on fees, rebates, discounts, and other compensation.
• PBMs may be required to pass through certain rebates and price concessions to the group health plan.
• A new ERISA provision requires PBMs to provide regular reports to group health plans, including drug cost data, utilization information and reporting at least every six months and quarterly, if requested by the plan.

Employer Action Items

• Review current PBM contracts for transparency provisions. Inadequate documentation of fee reasonableness may increase exposure during audits.
• Identify what compensation disclosures are currently available (and what is missing). Failure to properly assess PBM compensation could raise ERISA fiduciary concerns.
• Consider submitting comments to the DOL by April 15, 2026.