Electronic Funds Transfer

Fidelis Care offers Brokers the option to receive their commission checks through Electronic Funds Transfer directly to a financial institution of their choice. 

To enroll in Electronic Funds Transfer, please ensure that you have the information below readily available:
  1. Broker Name
  2. Broker Address
  3. Broker ID
  4. TIN or EIN (Please use SSN in absence of TIN)
  5. Broker Contact Information
  6. Financial Institution Information (Bank name, Routing number, Account number)
  7. Electronic image of a voided check or a direct deposit bank letter (the bank letter must be dated within 90 days of the application date and preferably notarized)

If you provide a voided check from your bank, it cannot be altered in any way. Information crossed out or handwritten information will not be accepted. 

In lieu of a voided check, a letter from your bank, with their letterhead, indicating your name, broker's SSN or Tax ID, account and routing number will be accepted.

If your banking institution has been acquired or merged and you are using run-out checks from the old bank, you must provide a letter from your bank that provides information about the acquisition or merger. 

The routing and account numbers for the new bank must be the same ones as those prior to the transaction.

The name and Tax ID on the W-9 that is on file at Fidelis Care must exactly match the broker/agency who is receiving the funds.

We anticipate the following timeline for steps in the process once all the required information is submitted: up to 10 business days for Penny Test deposit confirmation; up to 60 days for commission payments/changes after confirmation of successful Penny Test. 

If you have questions about the form, please call Fidelis Care Broker Services at 1-877-259-8428. You may also email your questions at brokerservices@fideliscare.org.

If you would like to receive your commission checks through Electronic Funds Transfer, please complete the EFT Enrollment

Questions? Commission Inquiries?

Call: 1-877-259-8428

Email: commissions@fideliscare.org
 

Statewide Contact: Gary Galletta, Broker Program Manager

Brokers must go to the broker manager to obtain an application. 

Broker Program Contact List (PDF)