In a group medical plan with an80% coinsurance provisionand no deductible, the insurer pays 80% of covered medical expenses, and the insured pays the remaining 20%. For Laura’s $1,000 medical bill, the insurer covers 80% ($1,000 × 0.80 = $800), and Laura pays 20% ($1,000 × 0.20 = $200). This calculation aligns with standard health insurance cost-sharing provisions in Oklahoma (Title 36 O.S. § 6060.3).
Option A: Incorrect. Laura must pay her coinsurance share, not $0.
Option B: Correct. Laura pays $200 (20% of $1,000).
Option C: Incorrect. $800 is the insurer’s share, not Laura’s.
Option D: Incorrect. Laura does not pay the full $1,000; she pays only her coinsurance portion.
[:, Prometric Oklahoma Life, Accident, and Health or Sickness Producer Exam Content Outline (Section: General Knowledge – Accident and Health Insurance)., Oklahoma Insurance Department, Title 36 O.S. § 6060.3 (health insurance policy provisions)., Standard insurance study guides (e.g., Kaplan, ExamFX) for Oklahoma producer licensing., ]
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