Affordable Care Act has changed the rules when it comes to insuring your child

The Affordable Care Act was signed in March 2010 and provisions of the law will be implemented through January 2015.

A major aspect of the legislation that local insurance agents have seen affect their customers are changes to rules governing coverage for children, which they say have ended up making options less affordable.

The law made it illegal as of September 2010 for insurance carriers to deny coverage for children younger than 19 based on pre-existing conditions. Young adults were also made eligible to stay on their parents' plans until the age of 26.

At the same time those provisions took effect, major insurance carriers nationwide eliminated the availability of stand-alone policies for children, requiring a parent to be insured on the same plan.

Charley Tinsley of Thomas Insurance Group in Cape Girardeau said he has seen more parents put their older eligible children on their plans, but overall, the changes in the availability of child coverage have driven costs up for parents.

"To me, it's hurt my clients," Tinsley said.

Parents can add their dependents to their employee benefits packages, drop off their work plans and seek independent insurance for themselves and their children, or obtain coverage through the Missouri Health Insurance Pool (MHIP).

Tinsley said he worries about where people will find affordable coverage for their children. Many agents don't realize that the MHIP is available, he said. Also, the incentive is lower to write MHIP policies because agents don't receive a standard commission.

Kim Beggs, insurance agent at Marathon Benefits Group in Cape Girardeau, said her agency has seen limitations in available options to parents, as well. Prices have risen for employers, too, and they have had to make changes to absorb the increased cost of plans for employees and dependents, she said. Businesses continually make adjustments to try to balance the expense, such as raising plan deductibles or requiring employees to pay more of a percentage of premiums.

"Every year you have to do something different," Beggs said.

In 2014, employers with 50 or more employees will be required to provide health care coverage to full-time workers and pay at least 60 percent of the cost, or face a penalty. Also next year, uninsured individuals who are considered by income level to be able to afford it will be required to obtain basic health insurance coverage or pay a fee.

Beggs said sometimes she receives a call from someone in a panic, worried about getting coverage to comply with the law, but not many people seem concerned yet.

Tinsley says it is hard to forecast what the effects on the industry will be as steps of the reform legislation continue to be implemented over the next few years. Prices haven't been set, he said. Nor have plan designs and agent compensation fees been established.

If agents are not paid for selling policies, he said, it could strain agents to the extent that they may not be able to stay in business, which could ultimately spell trouble for clients.

"Without insurance agents you're going to be at the mercy of an 800 number and somebody that may or may not care whether you get the help you need or not," Tinsley said.