don't want to pay a lot per month. We wanted [providers] to offer a product in that category. We wanted them to offer a product in a middle tier, which we call 'silver' - a balance between the monthly premium and the co-pay amount. We also wanted them to offer a more comprehensive package that might interest families."

The Connector contracted with six insurance providers, representing roughly 90 percent of the state's health insurance industry, according to the Connector.

"This was the first time consumers could really do this comparison across different health plans," Nevins said. "If you go to Harvard Pilgrim [a provider in the state], they wouldn't tell you what their competitors charge - it doesn't really serve their interest. Because we're an independent state authority, and because our charge is to help people purchase affordable health insurance, we're able to do this."

Back-End Operations

Citizens get locked into a rate for 12 months once they purchase a plan through the Connector site. However, providers change the promoted rates on a monthly basis. Those operating the back end of the site's operations must stay up-to-date on current prices.

The Connector pays the Small Business Service Bureau (SBSB), a private company, to receive providers' current rate information and run the Connector's insurance plan phone bank. The Connector considers the SBSB its "subconnector." The subconnector submits current rates to the Connector Authority via XML messages.

"It's a big dance going on between us, our subconnector and the carriers to make sure everybody is satisfied that what we're selling is, in fact, what the providers are offering," Nevins said.

The Connector initially paid the CSC $700,000 for the solution over six months. Since then, the agency has paid that amount twice more for two six-month extensions of CSC's help at running the site.

Nevins said the Connector will likely extend its contract for an additional six months from July to December 2008. "Then we're pretty much done with them. We'll operate the thing on our own," Nevins explained, adding he would likely add a few more IT staffers to keep information current on the site.

The Connector agency is fine-tuning the site's features that it didn't have time to perfect during the initial implementation. For example, it's changing the Java code powering the site to a "components-based" model, which would simplify site programming, said Nevins. The components-based approach would enable programmers to fashion "modules" of ready-to-use code they could apply elsewhere on the project.

Heads-Up to Others

States considering health insurance laws similar to Massachusetts' could learn from challenges Nevins faced during his quick rollout. For example, a state should plan to accommodate a larger number of uninsured residents than it initially estimates. The Connector's initial estimate put the number of uninsured at 370,000.

The true number, according to Nevins, was closer to 550,000. Costs rose higher than the Connector planned. The agency expected roughly 136,000 of the uninsured to sign up for Commonwealth Care. Instead, 176,000 people enrolled in the program.

The Connector also had to carefully craft communications when soliciting involvement from insurance providers. Insurance providers didn't want to appear to not support the state's health-care reform effort, said Nevins.

"On the other hand, here we were, having an impact on the market and creating more competition. We had to approach that gingerly," Nevins said.


Andy Opsahl  | 

Andy Opsahl is a former writer and features editor for Government Technology magazine.