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My husband's CO had a similar clause. You are to cover the insurance premiums. You pay the 1st $100 of medical payments per year. After that $100 you split the rest of medical that IS from a provider of the insurance 50/50. Next is if you go to an out of network provider. If you both agree than it is 50/50. If you want an out of network but he disagrees than your pay 75% of the cost after the insurance pays, he pays 25%. If he insists on having an out of network provider than he pays the 75% and you pay 25%. The out of network provider usually has more costs that the insurance doesn't cover. |