This sentence has 3-2 split with "imposing" and "that" and it is clear that a-b are wrong. However the problems lies between the answer choices D & E.
A) The word is spend is wrong because it has no subject and also it isn't parallel.
B) In this case all the tokens imposing, requiring and spending are all parallel, but that would mean the insurance plans do so - which is absurd.
C) similar case as B
D) By Process of Elemination. However the explaination is as follows. The verb tokens impose & require are parallel and logically modify plans and spending acts as a particple.
E) The verb tokens requiring & spending are parallel in the modifying clause, which implies that plans themselves spend time with the patients. however this does not make sense.
The point of confusion in this sentence is verbs which have to be in parallel and which should be not. You will have to judge this by the context of the sentence.