Page 110 - 2022 Washington Nationals Flipbook

MLB LWIP & Nationals Welfare
Plans and Summary Plan Description

Statute of Limitations. Any lawsuit seeking benefits under this Plan must be brought within
three years of when you or your representative (as applicable) first submitted the claim. In
the event that you do not submit a claim for benefits by the claim deadline applicable to a
particular benefit, then the claim will be deemed denied as of the claim deadline and the three
year Statute of Limitations will begin to run from the claim deadline.

PRIVACY OF HEALTH INFORMATION

The receipt, use and disclosure of protected health information by the Plan is governed by
regulations issued under HIPAA and the Health Information Technology for Economic and
Clinical Health Act. In accordance with these regulations, the Plan Administrator, certain
employees of the Plan and the Plan’s business associates may receive, use and disclose
protected health information in order to carry out payment, treatment and health care
operations under the Plan. These entities and individuals may use protected health
information for such purposes without your consent or written authorization. In addition,
your protected health information may be shared with the Nationals without your consent or
written authorization for administrative purposes. In the normal course, if your protected
health information is used or disclosed for any other purpose, your written authorization for
such use or disclosure will be required. See Appendix B, HIPAA PRIVACY & SECURITY OF
PROTECTED HEALTH INFORMATION, for more information.

CONTINUATION COVERAGE RIGHTS UNDER COBRA

When your eligibility for coverage in the LWIP, dental, vision, or Health Care
Reimbursement Account, you may have the right to COBRA continuation coverage, which is
a temporary extension of health coverage under the Plan. This section generally explains
COBRA continuation coverage, when it may become available to you and your family,
and what you need to do to protect the right to receive it. In this section, “Plan” means
the LWIP, dental, vision, and Health Care Reimbursement Account. When you become
eligible for COBRA, you may also become eligible for other coverage options that may cost
less than COBRA continuation coverage.

The right to COBRA continuation coverage was created by a federal law, the Consolidated
Omnibus Budget Reconciliation Act of 1985 (“COBRA”). COBRA continuation coverage
can become available to you when you would otherwise lose your group health coverage. It
can also become available to other members of your family who are covered under the Plan
when they would otherwise lose their group health coverage. For additional information
about your rights and obligations under the Plan and under federal law, you should contact
the Nationals.

You may have other options available to you when you lose group health coverage. For
example, you may be eligible to buy an individual plan through the Health Insurance
Marketplace. By enrolling in coverage through the Marketplace, you may qualify for lower
costs on your monthly premiums and lower out-of-pocket costs. Additionally, you may
qualify for a 30-day special enrollment period for another group health plan for which you
are eligible (such as a spouse’s plan), even if that plan generally doesn’t accept late enrollees.

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