Common use of Tiered Benefit Designs and Narrow Networks Clause in Contracts

Tiered Benefit Designs and Narrow Networks. (a) Provider acknowledges and agrees that nothing in this Agreement shall limit or otherwise prohibit Blue Shield from: (i) at any time developing, marketing and implementing: (A) tiered products, plans, benefit designs or Benefit Programs; (B) provider networks which tier or rank participating providers (including Provider) and where such tier or rank directly affects the Member’s and/or employer’s premium, copayment or cost share or restricts or limits network access; and/or (C) narrow, restricted or limited provider networks or products that require Members (or those who pay for their coverage) to pay more for the same (or substantially similar) product or benefit design to access all Blue Shield contracted providers compared to a network that does not include Provider (collectively, “Tiered/Narrow Products”); and (ii) except as expressly provided in Exhibit A hereto, including Provider in or excluding Provider from, or tiering or ranking Provider within, any such Tiered/Narrow Product. (b) Prior to excluding Provider from, or tiering or ranking Provider within, any Tiered/Narrow Product, Blue Shield shall provide written notice to Provider, reasonably prior to implementing or modifying the Tiered/Narrow Product, that explains in detail how the Tiered/Narrow Product will work and Provider’s status within the Tiered/Narrow Product.