Out of pocket costs involve payment to . . . . . . . . .

The correct answer is: A. outsiders.

Out-of-pocket costs are expenses that are paid directly by the individual, rather than being reimbursed by an insurance company or other third party. They can include things like medical bills, travel expenses, and childcare costs.

Option B, self, is incorrect because out-of-pocket costs are not paid to oneself. They are paid to someone else, such as a doctor, a hotel, or a daycare provider.

Option C, employees, is incorrect because out-of-pocket costs are not paid to employees. They are paid to vendors or service providers.

Option D, None of the above, is incorrect because out-of-pocket costs are paid to outsiders.