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Many sign up for Mass. health insurance, but few have paid

Fewer than 1 percent of the people who learned they are eligible to buy health insurance plans on the Massachusetts Health Connector have taken the next critical step: paying for their coverage.

Connector officials said that is to be expected, because the bills for 2015 coverage are not due until Dec. 23.

But the Massachusetts Association of Health Plans has raised concerns about the low enrollment numbers, as the Connector braces for the challenge of getting people who applied for coverage to select plans and pay for them.

The Connector website has successfully determined what coverage about 150,000 people are eligible for — a task last year’s dysfunctional website could do for no one.

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“We’ve seen none of the issues with the performance of the system that we saw last year,” Maydad Cohen, the top official overseeing the website’s rebuilding, told the Connector Board Thursday. “The new system really is outpacing the old system across every data set.”

The Connector is a state agency that enables people who do not get insurance through their employers to shop for coverage and obtain subsidies to lower their premiums.

Created by state law in 2006, the Connector needed to upgrade its website last year to comply with the federal Affordable Care Act. The software failed disastrously, and much of the past year has been devoted to adapting software by the Virginia tech company hCentive to build a working website for Massachusetts.

The new website, launched Nov. 15, has functioned well so far, but its ultimate success depends on getting health insurance cards into the hands of consumers.

In the first 25 days of open enrollment, 68,100 people have been enrolled in MassHealth, the state’s Medicaid program.

An additional 79,464 have learned they are eligible to buy private insurance purchase through the Connector, with about 60 percent qualifying for federal or state subsidies. It is the people with private insurance who pay premiums.

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But only 3,729 have paid their first month’s premiums.

“The history suggests that individuals do not pay until they have to,” Cohen said. “The week before the deadline is when we expect most people to pay. Remember, we’re talking about low-income people. They do not have income sitting around in their checking accounts.”

Lora Pellegrini, president of the Massachusetts Association of Health Plans, sent a letter to the Connector on Wednesday expressing concern about the low enrollment. “We are concerned about the potential for thousands of individuals being uninsured if the anticipated volumes are not realized,” the letter said.

“Our concern is that we stay very focused on reminding folks to select a plan and pay, and that the state’s able to handle the volume if it all comes in the last two weeks of the year,” Pellegrini said in an interview. “That is going to be a daunting task. Based on what happened last year, our job is to keep everyone’s feet to the fire.”

In addition to the low enrollment numbers, she asserted that the state was behind schedule in testing for its next big task — accepting changes to applications.

Currently, once an application is submitted, the consumer cannot change it. Those who experienced life events, such as job loss, that change their eligibility for assistance can ask a consumer service representative to make the change. But any other changes have to wait until Monday.

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Pellegrini said there had been “multiple repeated extensions of the testing window” for the ability to handle these changes.

Cohen disagreed, saying the state was on track. “We’re not behind schedule,” Cohen said. “We got similar concerns from the plans before we went live on Nov. 15 and that turned out fine.”

Making changes will not require a great deal of time by the call center staff, Cohen said. In most cases, consumers will call in and agents will unlock their applications so they can make the changes on their own.

Cohen said the transition team for Governor-elect Charlie Baker asked him to stay on until the end of open enrollment on Feb. 15, and he agreed.


Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer