Document ID: ./input/supremecourt_opinions/opinions/20pdf/18-540_m64o.pdf
Page Number: 10.0

Cite as:  592 U. S. ____ (2020) 

7 

Opinion of the Court 

ERISA  plans  because  it  applies  to  PBMs  whether  or  not 
they manage an ERISA plan. Indeed, the Act does not di-
rectly regulate health benefit plans at all, ERISA or other-
wise.  It affects plans only insofar as PBMs may pass along 
higher pharmacy rates to plans with which they contract. 
  ERISA plans are likewise not essential to Act 900’s oper-
ation.  Act 900 defines a PBM as any “entity that adminis-
ters or manages a pharmacy benefits plan or program,” and 
it defines a “pharmacy benefits plan or program,” in turn, 
as any “plan or program that pays for, reimburses, covers 
the cost of, or otherwise provides for pharmacist services to 
individuals who reside in or are employed in [Arkansas].”  
Ark. Code Ann. §§17–92–507(a)(7), (9).  Under those provi-
sions,  Act  900  regulates  PBMs  whether  or  not  the  plans 
they service fall within ERISA’s coverage.1  Act 900 is there-
fore analogous to the law in Travelers, which did not refer 
to ERISA plans because it imposed surcharges “regardless 
of  whether  the  commercial  coverage  [was]  ultimately  se-
cured by an ERISA plan, private purchase, or otherwise.”  
514  U. S.,  at  656;  see  also  Dillingham,  519  U. S.,  at  328 
(concluding that the relevant California law did not refer to 
ERISA plans because the apprenticeship programs it regu-
lated did not need to be ERISA programs). 

III 
  PCMA disagrees that Act 900 amounts to nothing more 
than cost regulation.  It contends that Act 900 has an im-
permissible connection with an ERISA plan because its en-
forcement mechanisms both directly affect central matters 
of  plan  administration  and  interfere  with  nationally  uni-
form  plan  administration.    The  mechanisms  that  PCMA 
identifies,  however,  do  not  require  plan  administrators  to 
structure their benefit plans in any particular manner, nor 

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1 PBMs contract with a variety of healthcare plans and programs that 
are not covered by ERISA, including Medicaid, Medicare, military, and 
market place plans.