The files certify whether a person is, in fact, enrolled and whether he or she is eligible for subsidies that help determine monthly premium amounts. There are reports the accuracy of the file information has improved.
But it's far from unthinkable that you could have done everything right - and then arrive in an emergency room, go to a doctor's appointment, or pick up a prescription at the pharmacy, and find you're not listed in your insurer's records. Coverage doesn't begin for four days, but people already have gone missing in cyberspace.
So how do you make sure you're accounted for? If you signed up at the last minute, you likely won't see a bill right away. More than 2 million people visited the website in the final few days, according to the White House.
So, patient, have patience. Give it a week or two. If you still haven't heard, call your insurer.
If you bought a policy in, say, October or early November and haven't received a bill, your application may be misplaced.
Independence Blue Cross has created a team of sleuths who sift through the file transfers, searching for lost applications. Locating one may take from a few hours to a couple of days, depending on the circumstances, said Paula Sunshine, IBX vice president for consumer affairs.
When your paperwork is found, your claim will be covered back to Jan. 1, she said.
"We do have an internal process, a triage process, where we have a team of people who will go back though the file transfers so we can find that application and get that person enrolled," Sunshine said. "We are absolutely committed to honoring every application. We are really trying to do the right thing."
To lessen the chances enrolled customers will discover they are not in the system when they try to use their insurance, IBX, the area's largest health insurer, announced last week it was pushing back the due date for the first premium payment to Jan. 28. The company sent letters informing customers of the change, along with instructions on how to get a temporary ID card.
"If you have not gotten your identification card by Jan. 1, you will get instructions about how to go online and print a temporary card," Sunshine said.
Meanwhile, the Obama administration announced that, due to problems with the website rollout, there will be a "special enrollment period." Details have not been announced.
IBX already plans a Jan. 9 "Enroll-a-thon" to keep the momentum going and to remind people that health insurance enrollment will continue through March 31. But to have coverage beginning Feb. 1, you must chose and pay the first month's premium by Jan. 15.
"What we saw in the first quarter are people who understand the value of health insurance, who have insurance, and may be replacing an existing plan," Sunshine said. "We will continue to see demand all the way up to March 31, but it will be a different part of the population. We will continue our effort to educate people who may be buying insurance for the first time."
Robert Calandra can be reached at 215-836-0101 or RTCaca@verizon.net
This article was produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente.