Both husband and wife have group health insurance through their employers.

Thecoordination of benefits (COB)provision, as regulated in Oklahoma (O.A.C. 365:10-5-4), prevents overinsurance when an individual is covered by multiple health plans. For spouses, theprimary insureris typically the wife’s employer plan for her claims, as it covers her as an employee. Thesecondary insurer(the husband’s plan) pays any remaining covered expenses up to its policy limits, ensuring the total payment does not exceed the loss.

Option A: Incorrect. Both insurers may pay under COB, not just the wife’s insurer.

Option B: Incorrect. The secondary insurer may also pay if the primary does not cover the full loss.

Option C: Correct. The primary insurer (wife’s plan) pays first, and the secondary insurer (husband’s plan) pays the remainder, per COB rules.

Option D: Incorrect. The husband’s insurer is secondary, not primary, for the wife’s claim.

This question aligns with the Prometric content outline under “Provisions, Options, Exclusions, Riders, Clauses, and Rights,” which covers coordination of benefits.