Terms and Conditions

Terms of Use

Thank you for using the Massachusetts Health Connector website. We hope this site helps you understand your requirements related to Health Care Reform and provides you with an easy way to meet those requirements. This document contains terms of use this website:

  1. By using this website you agree to these terms and conditions. In addition, you should also review our Privacy Policy to learn about information collected by the Massachusetts Health Connector, what that information is used for, and how it may be shared.
  2. For your convenience, this website contains hypertext or other links to external Internet sites that are not provided or maintained by the Massachusetts Health Connector. Please note that we strive to ensure the highest level of accuracy regarding the information provided by these external Internet sites, but we cannot guarantee the accuracy, relevance, timeliness, or completeness of these external sites. In addition, the inclusion of links to non-governmental sites is not intended to endorse any views expressed, or products or services offered, on these sites, or the organizations sponsoring the sites.
  3. All of the material posted on this website and accessible to the public without use of an authenticating and authorizing mechanism (such as a “PIN” or password) is public record. Most of the public record posted on Commonwealth websites can be copied and used for any purpose. For example, all regulations and all laws and regulations are public record.

With respect to material copyrighted by the Commonwealth, including the design, layout, and other features of this website, the Massachusetts Health Connector forbids any copying or use other than “fair use” under the Copyright Act. “Fair use” includes activities such as criticism, comment, news reporting, teaching, research, and other related activities. In addition, please be advised that the Massachusetts Health Connector makes use of materials (including, but not limited to, photographs) copyrighted by third parties, which also cannot be copied or used for use other than “fair use” without permission of the copyright owner. If you want to make use other than “fair use” of any copyrighted information on this website, you must seek permission directly from the copyright owner.

The Massachusetts Health Connector makes no warranty that the materials contained within this website are free from copyright claims, or other restrictions or limitations on free use or display. The Massachusetts Health Connector disclaims any liability for the improper or incorrect use of information obtained from this website.

You agree that your use of this Site and any disputes relating thereto shall be governed in all respects by the laws of the Commonwealth of Massachusetts. Any dispute relating to this Agreement shall be resolved solely in the state courts located in Boston, Massachusetts.

Premium Billing and Payments Policies

Applicable to all Health Connector Products (Non-Group and Small Group Qualified Health Plan or QHP/Qualified Dental Plan or  QDP)

Payee Entity

Individuals and families subject to premium may elect to pay the Health Connector or the issuer directly. Exceptions are ConnectorCare-eligible individuals/families who receive state financial assistance and small groups enrolled under the Standard Operating Model; those groups may only pay the Health Connector.

Once the enrollee chooses the payee entity, that choice cannot be changed until the end of the plan year.

Premium Billing Responsibility

If the enrollee chooses to pay the issuer directly, the issuer is responsible for establishing a process for collection of premium payments. This process is to be compliant with t he provisions of the Affordable Care Act and consistent with the Health Connector’s processes.

If the enrollee chooses to pay the Health Connector, the Health Connector’s Customer Service Center is responsible for premium billing, processing payments and updating appropriate systems in accordance with the Health Connector’s and Customer Service Center’s internal policies and procedures.

Initial Payment Process and Deadline

Initial Payment Due Date for all non-group products is the 23rd calendar day of the month before coverage effective date. Initial Payment Due Date for small group products varies by product type. Please see the Enrollment Timelines policy for the applicable initial payment due dates. 1

Paying the Health Connector:

  1. The Health Connector generates the initial bill and sends to the
  2. The enrollee pays the initial bill using one of the available payment
  3. The Health Connector processes enrollment and transmits daily enrollment confirmation to the issuer.
  4. The issuer effectuates enrollment daily and produces member ID number and generates member packet and card mailing to enrollee.

Paying the Issuer:

  1. The Health Connector transmits daily to the issuer the enrollee’s health plan and product selection as well as all other necessary
  2. The issuer transmits to the Health Connector daily confirmation of payment
  3. The Health Connector processes enrollment and transmits daily enrollment confirmation to the issuer.
  4. The issuer effectuates enrollment daily, produces member ID number, and generates member packet and card mailing to enrollee.

Ongoing Payment Process and Deadline

The Ongoing Payment Due Date for all non-group and small group products is the date specified by the individual carrier prior to the month of enrollment for which the payment is due. An enrollee must pay his/her monthly premium in full by the payment due date each month . Payment must be received by the payment due date each month.

Paying the Health Connector:

If the enrollee chooses to pay the Health Connector:

  • The monthly bill is generated on the 1st of each month and mailed to enrollee
  • The monthly bill is delivered to enrollee by mail within 6 business days after the 1st of the month
  • The monthly bill is for the next month’s coverage
  • The monthly payment is due on the 23rd calendar day of the month for all non-group products and 5 business days before the first of the next month for all small group products

Paying the Issuer:

An enrollee must pay his/her monthly premium in full by the payment due date each month in accordance with the process established by the issuer.

Several payment methods are available:

  • Payment via mail by check or money order
  • Payment by one time or monthly AutoPay (recurring Electronic Funds Transfer (EFT)) using the Health Connector’s secure online system or guest payment portal at paymentcenter.mahealthconnector.org
  • Payment by check or money order dropped off in person at any of the Walk-In Center Locations
  • Payment via mail or electronically sent by the enrollee’s bank or financial institution

Payments are processed and credited to enrollee’s account the same day they are received, provided the payment was submitted in accordance with the procedure established by the Health Connector.

Payment Procedure

If the enrollee chooses to pay the Health Connector, s/he must follow the proper steps for making a payment. The most updated information on how to make a payment, including useful links, can be found on the How to Pay page of the Health Connector website.

Customers shall designate the policy to be paid when making an online payment. When paying online whether by one -time or AutoPay (recurring Electronic Funds Transfer), the system will require such designation for each payment. For guest payments, an identification number, such as the Billing Account Number or Enrollment ID associated with the enrollment the payment should be credited to is required to make a payment.

When using other payment methods, the customer shall include either his/her detachable payment coupon located at the bottom of the bill or complete account number as described in the Payment Procedure section above.

Payments that are designated to medical or dental plan shall be applied according to the specified designation.

For payments with no designation of allocation to medical or dental plan, the payments will be applied to fees first (if applicable), then to the oldest balance on account.

Improperly submitted payments

If the Health Connector receives a payment that does not contain sufficient or correct information on or with it and lack of information/ incorrect information results in the Health Connector not being able to promptly and properly credit the payment to the enrollee’s account, the payment may be not applied or applied late to the enrollee’s account as a result of incorrect or missing information. In this case, enrollee’s account will be considered delinquent and/or enrollee will be subject to disenrollment or enrollment will not be effectuated.

Late Payments

An enrollee must pay his/her monthly premium in full by the payment due date each month. A payment received after the payment due date is treated as non -payment for the purposes of effectuating enrollment, calculating delinquency status, and terminations for non-payment. A late payment may result in:

  • The suspension or denial of claims by the issuer for healthcare services rendered for enrollee(s)
  • Effectuating enrollment with a later effective date or not effectuating enrollment for enrolling individuals, families, employers, or employees

Returned Payments

If an enrollee’s payment is returned for insufficient funds, the Health Connector will process payment return and update appropriate systems. The Health Connector will notify the enrollee. If the enrollee is enrolled in monthly AutoPay (recurring EFT) using the Health Connector’s online system and a payment is returned for insufficient funds, the Health Connector will change the payment method for the enrollee to paper. The enrollee can establish a new recurring EFT at a later time.

Unless a new payment is made promptly, returned payment will result in account delinquency. If so, the Health Connector will notify the issuer of the account delinquency status.

The Health Connector may, in its sole discretion, charge the enrollee the fees that the Health Connector is charged by its bank or financial institution for returned payments. The Health Connector may, in its sole discretion, request that enrollee pay by a bank check or money order in cases where an enrollee has had more than three (3) occurrences of returned payments in a ninety (90) day period provided that all three (3) payments were made by the same payment method.

Resolution of Improperly Submitted Payments

Payments that are not submitted pursuant to this policy will be held in a suspended account while the Health Connector conducts research in order to apply them correctly.

Charges and Fees

The Health Connector is not responsible for fees charged by the enrollee’s bank or financial institution.

The Health Connector may, in its sole discretion, charge the enrollee the fees that the Health Connector is charged by its bank or financial institution. In this case, the Health Connector will notify the enrollee of such charges on the invoice generated in the billing cycle subsequent to the date payment was returned. The fee charged to the enrollee shall not exceed the fee the Health Connector is charged by its bank or financial institution.

1. Please reference the policy Enrollment Timelines (SB-6A)

Terms and Conditions for and Stored Payment Methods

Please read the following carefully. By agreeing to set up automatic payments through “My AutoPay ” or by agreeing to store payment method information, you agree to the following terms and conditions. You agree that you are the owner of, or that you are otherwise authorized to make payments using, the checking or savings account associated with the information you enter, and you authorize the Massachusetts Health Connector to store that account information. You authorize the Massachusetts Health Connector to use this information to initiate an automated clearing house (ACH) debit entry(ies) from the account you specify. If you are setting up automatic payments through “My AutoPay Setup,” you agree that these automatic payments will occur every month on the date specified, unless you cancel AutoPay. You also agree that the amount of your automatic payments will be the amount of the premium owed, and this amount will change automatically to match the amount of your premium, if the amount of your premium changes. If you are storing the payment method for use in one-time payments, you agree that those payments will occur on the date and in the amount you specify on the payment information screen shown during the payment process. You agree to be bound by any rules your financial institution requires for ACH debit transactions. THE MASSACHUSETTS HEALTH CONNECTOR SHALL BEAR NO LIABILITY OR RESPONSIBILITY FOR ANY LOSSES OF ANY KIND THAT YOU MAY INCUR AS A RESULT OF AN ERRONEOUS STATEMENT OR INVOICE, ANY DELAY IN THE ACTUAL DATE ON WHICH YOUR ACCOUNT IS DEBITED, OR YOUR FAILURE TO PROVIDE ACCURATE AND/OR VALID PAYMENT INFORMATION. The Massachusetts Health Connector reserves the right to change these terms and conditions at any time. Notice of any such change may be given on or with your bill or by other methods, including, but not limited to email. These terms and conditions are in addition to and not in lieu of any other agreements between you and the Massachusetts Health Connector. Please refer to the Health Connector’s Site Policies for additional terms governing your use of these services.