Page 166 - 2022 Washington Nationals Flipbook
P. 166
ERISA SUMMARY PLAN DESCRIPTION INFORMATION
Name of Plan: Life, AD&D and Dependents Life Insurance
Name, Address of Plan Sponsor: Washington Nationals Baseball Club, LLC
1500 S Capitol Street SE
Washington DC 20003
Plan Sponsor Tax ID Number: 20-5145890
Plan Number: 502
Type of Plan: Group Insurance Plan
Type of Administration: Contract Administration
Name, Address, Phone
Number of Plan Administrator: Plan Sponsor
(202) 640-7000
Name, Address of Registered Agent
for Service of Legal Process: Plan Administrator
If Legal Process Involves Claims
For Benefits Under The Group Standard Insurance Company
Policy, Additional Notification of 1100 SW 6th Ave
Legal Process Must Be Sent To: Portland OR 97204-1093
Employer/Member
Sources of Contributions: Standard Insurance Company - Fully Insured
Funding Medium: December 31
Plan Fiscal Year End:
Printed 01/29/2015 -8- 151138-D
