What Changed
Wellcare has told brokers that Wellcare Fidelis Simple and Wellcare Fidelis Assist in New York will be commissionable and available for sale. Both plans are offered by New York Quality Healthcare Corporation under the Wellcare by Fidelis Care brand, part of Centene. The carrier’s official communication with full details, including compensation and any effective dates, is expected today. We’ll update brokers as soon as we receive it.
In the carrier’s plan documents, both plans are listed as HMO-POS plans. The point-of-service benefit applies only to routine dental care, so for medical care members must use the Wellcare by Fidelis Care network except in emergencies and other limited situations.
Broker Takeaway
Commissionable status matters for both sides of the table. Brokers can now present these $0-premium options to every suitable New York client without a compensation conflict, and clients get a full, fair comparison instead of a shortened list.
Side-by-Side: Simple vs. Assist for 2027
Here are the key 2027 benefits from each plan’s Summary of Benefits: Wellcare Fidelis Simple and Wellcare Fidelis Assist. Always confirm details in the Evidence of Coverage and Medicare Plan Finder before you enroll anyone.
Which client fits which plan? Fidelis Assist suits clients who see specialists often or want help with hearing aids, eyewear and over-the-counter items. Fidelis Simple suits clients who mainly want dental care with no annual cap and are comfortable with the $430 deductible on select Part B services. Neither plan covers routine transportation. Compare total expected costs, not just premiums.
Where the Plans Are Available
According to the Summaries of Benefits, both plans serve the same 58 New York counties. That includes the Bronx, Brooklyn (Kings) and Manhattan (New York), Nassau, Suffolk, Westchester, Erie, Monroe, Albany and most of upstate New York. Four counties are not on the 2027 list: Queens, Richmond (Staten Island), Onondaga (Syracuse) and Tompkins (Ithaca). Check the client’s county against the plan’s official service area before quoting.
Many current Wellcare members are being moved into these plans. The carrier’s notices show that Wellcare Simple (H4868-019) is being combined into Wellcare Fidelis Simple, and Wellcare Assist (H4868-016) into Wellcare Fidelis Assist, starting January 1, 2027. Those clients will be enrolled automatically unless they choose another plan by December 7, which makes this a natural reason for a review call.
Your Next Steps
- Confirm you’re ready to sell. Check that your Wellcare appointment and 2027 certification are complete and that both plans show as available in your quoting and enrollment tools.
- Watch for today’s carrier communication and read the compensation details before quoting these plans as commissionable.
- Pull your New York book. Flag clients in Wellcare plans being combined into these two, plus clients whose plans are ending or cutting benefits.
- Complete a Scope of Appointment before discussing these plans. See our Scope of Appointment rules.
- Run each client’s doctors and drugs through the Wellcare by Fidelis Care directory, the formulary and Medicare Plan Finder.
- Document why each client chose their plan, whether or not it’s one of these two.
- Submit before December 7. Aim to finish by December 5 so applications have time to process.
For broader context, see our Wellcare AEP 2027 guide, the 2027 carrier exits guide and our AEP final checklist. If a client’s plan is being discontinued, Medicare’s Special Enrollment Period rules may give them extra time after December 7.
How Affordable Care Agents Supports New York Brokers
Affordable Care Agents is a national FMO, IMO and insurance brokerage with deep roots in New York. If you’re new to the model, here’s what an FMO does for brokers. Our brokers get:
- Wellcare contracting and help confirming ready-to-sell status
- Real-time carrier updates like this one, the day they happen
- Compliance guidance on Scope of Appointment, call recording and documentation
- Live support from our team through the end of AEP. Call (646) 233-1499
- AHIP 2027 at a discount through our OIM partnership. See our AHIP 2027 certification guide and 2027 carrier certification guide
Ready to Sell Wellcare Fidelis This AEP?
Get contracted with Affordable Care Agents, confirm your Wellcare appointment, and get live help before December 7.
Call our team at (646) 233-1499. Still need AHIP 2027? Complete it at a discount through our OIM partnership.
Frequently Asked Questions
Disclaimer: This article is provided for educational and informational purposes only and should not be considered legal, tax, financial, medical, insurance, or compliance advice. Insurance laws, Medicare and Medicaid regulations, Affordable Care Act (ACA) Marketplace rules, carrier policies, commissions, plan availability, eligibility requirements, and state regulations may change without notice and vary by jurisdiction. Readers should verify all information through official sources such as CMS, Medicare.gov, Healthcare.gov, the IRS, applicable state Departments of Insurance, and insurance carriers before making insurance or business decisions. Affordable Care Agents is a national Field Marketing Organization (FMO), Insurance Marketing Organization (IMO), and insurance brokerage. Publication does not constitute an offer of insurance or a guarantee of coverage, contracting, compensation, eligibility, or regulatory compliance. We are not connected with or endorsed by the U.S. government or the federal Medicare program.
