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Insurers extend fee deadlines as signups surge on federal, state marketplaces

– The nation’s health insurance industry decided Wednesday to extend the deadline until Jan. 10 for Americans to pay for coverage that starts on New Year’s Day, as enrollment through the new federal and state insurance marketplaces appears to be surging.

After meager participation during the first two months, more than half a million people have chosen plans in the federal exchange since the beginning of December, according to government figures that have not been made public. Several states running their own exchanges are reporting sizable enrollment upswings as well.

Just a few days remain before a Monday deadline to sign up for coverage that will begin Jan. 1, and the last-minute blitz that federal health officials have predicted appears to be materializing. It puts intense pressure on insurers to send bills to their new customers – and on consumers to pay right away.

Under government rules, coverage cannot begin until people pay their first month’s premium. Extending the payment deadline creates breathing room for the industry and for people who are eager for their insurance to begin, averting a holiday week in which tens of thousands of Americans might not know whether their coverage would start on time.

The extension does not change the Dec. 23 sign-up deadline. But the move suggests that private health insurance companies, whose leaders spent much of the fall griping about problems with the federal enrollment marketplace, are entering a new phase in which they are worrying about how to handle an onrush of insurance-seekers.

The deadlines mark pivotal moments in the fate of the Affordable Care Act, a broad 2010 law intended to reshape health care in the United States, in part by slashing the ranks of the uninsured. As of Jan. 1, the day the new coverage will begin, most Americans will for the first time be required to have health insurance or risk a fine.

The enrollment period for health plans in the federal marketplace began Oct. 1, but many people shopping for coverage were hampered by serious technical defects with the federal website, which administration officials say has significantly improved.

The board of directors of America’s Health Insurance Plans, the industry’s main trade group, decided on the extension Wednesday. Its move goes beyond a time frame envisioned by the Obama administration, which last week directed insurers in the exchanges to give customers until New Year’s Eve to pay for health plans that start the next day.

Insurers are sorting out rules for handling the increasing volume of customers. According to government figures, about 680,000 people had enrolled in plans as of earlier this week.