Terms and Conditions

• Your insurance card
• Your insurance information including Claim Number, Insurance Company name, Agent's name, and/or Adjuster's name
• Your policy information (Policy Number) and a description of your problem
• Your claim number
• Any electronic documents you would like to attach to your complaint (You will have the opportunity to attach documents once your complaint is successfully submitted)

• Protect you by enforcing Louisiana’s insurance laws
• Provide you with consumer information
• Investigate your complaints against companies, agents, or adjusters

• Give you legal advice, act as your lawyer or interfere in a pending lawsuit
• Recommend one insurance company, agent, or adjuster over another
• Decide disputes based on who is negligent or at fault
• Determine the facts surrounding a claim (that is who might be telling the truth in a matter when accounts of that matter differ)
• Resolve a complaint if the only evidence is your word against the word of others

-or-

Click here to print out a mailable paper version of the complaint form.

Terms and Conditions

• Any correspondence between yourself and the PBM/HII pertinent to the applicable prescription filled.
• The claim you filed with the PBM/HII, if applicable.
• A copy of the PBM’s final decision, if the complaint results from a denied appeal regarding maximum allowable cost (MAC) list pricing.
• The insured’s insurance ID card (copied front and back), if possible.
• Any additional supporting documentation in possession of the pharmacy.

• Protect you by enforcing Louisiana’s insurance laws pursuant to La. R.S. 22:1851‐1865, et seq.
• Provide you with additional information relevant to your complaint file.
• Investigate your complaints against Pharmacy Benefit Managers (PBMs) and Health Insurance Issuers (HII).

• Determine treatment efficacy with regard to prescription drugs.
• Issue directives related to how the formulary should be established.

-or-

Click here to print out a mailable paper version of the PBM complaint form.