Broker Resources

Resource  Link
Flex Benefit Flyer Click Here (.pdf)
Transition to the New Medicare Numbers and Cards  Click Here (.pdf)  
Dual Advantage Training Presentation  Click Here (.pdf) 
Form: Elderly Pharmaceutical Insurance Coverage (EPIC) Application Click Here (.pdf)
Free Interpreter Services Language List Click Here (.pdf)
Off-Exchange Application Instructions  Click Here (.pdf)
OTC Flyer Click Here (.pdf)

My Advocate 

Click Here

Online Medicare Application Process
Click Here (.pdf)

Online Medicare Application

Click Here

Medicare Enrollment Application

Click Here (.pdf)
Medicare Special Enrollment Periods Click Here (.pdf)
Producer Program Contact List Click Here (.pdf)

Enrollment Kit: Medicare Advantage $0 Premium (001), Medicare Advantage Flex, Medicare Advantage Without Rx 

Click Here (.pdf) 
Enrollment Kit: Medicare Advantage $0 Premium (002), Medicare Advantage Without Rx 

Click Here (.pdf)

Comparison Grid: Medicare Advantage $0 Premium (001), Medicare Advantage Flex, Medicare Advantage Without Rx 

Click Here (.pdf)
Comparison Grid: Medicare Advantage $0 Premium (002), Medicare Advantage Without Rx 

Click Here (.pdf)
Comparison Grid: Dual Advantage Products 

Click Here (.pdf)
Comparison Grid: Metal-Level Products 

Click Here (.pdf)
Comparison Grid: Essential Plans 

Click Here (.pdf)
Comparison Grid: Silver Plans 

Click Here (.pdf)

Coverage Area: Child Health Plus, Medicaid, MLTC, and NY State of Health 

Click Here

Coverage Area: Medicare Advantage and Dual Advantage 

Click Here

Provider Directory (Find a Doctor Search)

Click Here

Formulary: Fidelis Dual Advantage, Fidelis Medicaid Advantage Plus and Fidelis Dual Advantage Flex 

Click Here (.pdf)
Additional drug list for Fidelis Dual Advantage and Fidelis Medicaid Advantage Plus

Click Here (.pdf) 
Formulary: Fidelis Medicare Advantage Flex (HMO POS) and Fidelis 
Medicare $0 Premium (HMO) 

Click Here (.pdf)

Part B Diabetic Supplies

Click Here (.pdf)
Formulary: Child Health Plus, Medicaid  Click Here (.pdf)
Formulary: Metal-Level Products  Click Here (.pdf)
Formulary: EP  Click Here (.pdf)

Fidelis Care Products 

Click Here
Form: Scope of Appointment

Click Here (.pdf)

Form: Online Enrollment  Click Here (.pdf)
Form: Medicare Application Click Here (.pdf)
Form: MLTC Referral Form  Click Here (.pdf)
Medicare Star Ratings  English (.pdf)
Español (.pdf)
HIPAA Privacy Release Form  Click Here (.pdf)
HBX Approval Rate Manual
Click Here (.pdf)

Summary of Benefits: Medicare Advantage $0 Premium (001), Medicare Advantage Flex, Medicare Advantage Without Rx 

Click Here (.pdf)

Summary of Benefits: Medicare Advantage $0 Premium (002), Medicare Advantage Without Rx 

Click Here (.pdf)
Summary of Benefits: Dual Advantage and Dual Advantage Flex  Click Here (.pdf) 
Summary of Benefits and Coverage: Essential Plan 1 Click Here (.pdf) 
Summary of Benefits and Coverage: Essential Plan 2 Click Here (.pdf)
Summary of Benefits and Coverage: Essential Plan 3 Click Here (.pdf) 
Summary of Benefits and Coverage: Essential Plan 4 Click Here (.pdf)
Summary of Benefits and Coverage: Fidelis Care Bronze  Click Here (.pdf)
Summary of Benefits and Coverage: Fidelis Care Silver  Click Here (.pdf)
Summary of Benefits and Coverage: Fidelis Care Silver 250  Click Here (.pdf)
Summary of Benefits and Coverage: Fidelis Care Gold  Click Here (.pdf)
Summary of Benefits and Coverage: Fidelis Care Platinum  Click Here (.pdf)
Summary of Benefits and Coverage: Fidelis Care Catastrophic  Click Here (.pdf)