Page 140 - Washington Nationals 2023 Benefits Guide -10.26.22_Neat

MLB League-Wide Insurance Program
Plan and Summary Plan Description

which Participants need not be the same Participants who made contributions under the policy
that issued the rebate. Any portion of the rebate that is not treated as plan assets will be
allocated among one or more of Participating Employer(s) as the Plan Sponsor in its sole
discretion determines appropriate.

Termination Of Coverage. Generally, if you terminate your employment with your Employer
you will remain covered through the end of the month in which such termination occurs.
Dependent coverage generally ends on the first day of the month following the month in which
they turn 26. Please note that your Employer may have established different rules regarding
termination of benefits. Please see Appendix A for the specific rules applicable to your
Employer.

In addition, under federal law, you and your dependents may be entitled to continuation of
medical coverage. The section of this booklet entitled CONTINUATION OF COVERAGE UNDER
COBRA describes certain circumstances under which medical coverage may be continued after
the date coverage would otherwise end.

Dental Coverage

This section briefly summarizes the dental benefits that may be available to you under the Plan
and describes some important rules regarding your annual elections under the Plan. For a more
complete description of the benefits available under each coverage option, please refer to the
separate descriptive booklets that you have received from the Board, your Employer, insurance
companies, and other organizations with which the Board has contracted to provide benefits.

Your Employer may provide dental benefits, and if so, the available coverage options are listed
on Appendix A. You are responsible for making decisions regarding the coverage option you
choose (if more than one option is available to you) and your selection of dentists and other
dental providers. You also have the option to waive the dental coverage provided by your
Employer.

In addition, you and your dentist are responsible for choosing the course of treatment for (or
for choosing not to treat) any illness, injury or other dental condition. The Board and/or your
Employer are not in any way responsible for the outcome of any dental treatment or care (or
lack of such treatment or care).

You should refer to the benefit booklets distributed to you to answer specific coverage
questions and to help you decide which options (if more than one option is available to you)
are right for you and your family. Copies of these benefit booklets are also available from your
Employer.

CLAIMS PROCEDURE

Please refer to the booklets and other descriptive materials you have received from the Board,
your Employer and insurance companies for the Plan’s claims procedures. These booklets and
other materials that describe a particular benefit under the Plan will contain a specific set of
claims and appeals procedures that you must follow to make a claim to receive that particular
benefit and/or to appeal a denied claim for that particular benefit. Although these separate

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