Apologize in advance if this has been discussed already

This is D .
A B is out because we need "that"

C sounds as if insurance plan is spending time with patients.
Same with E . insurance plan is requiring doctors..to ...and spending ..

Its doctors which will "see more patients, spending less .."
impose and require are paralled ..and to see and spending are parallel here

Among lower- paid workers, union members are less likely than non union members to be enrolled in lower- end insurance plans imposing stricter limits on medical services and requiring doctors to see more patients, and spend less time with each.
a). imposing stricter limits on medical services and requiring doctors to see more patients, and spend
b). imposing stricter limits on medical services , requiring doctors to see more patients, and spending
c). that impose stricter limits on medical services, require doctors to see more patients, and spend
d). that impose stricter limits on medical services and require doctors to see more patients, and spending
e). that impose stricter limits on medical services, requiring doctors to see more patients and spending

Tough...

It seems B.
A is unparalleled, C says that the limits spend less time....impossible. D is unparalleled. E makes the same mistake as C.

In D, the "and spending" threw me off - if the "and" wasn't there it would be the clear choice

Thanks for explanations