Page 247 - Washington Nationals 2023 Benefits Guide -10.26.22_Neat

COVERAGE FEATURES

This section contains many of the features of your group life insurance. Other provisions, including
exclusions and limitations, appear in other sections. Please refer to the text of each section for full
details. The Table of Contents and the Index of Defined Terms help locate sections and definitions.

GENERAL POLICY INFORMATION

Group Policy Number: 151138-D
Type of Insurance Provided:
Life Insurance: Yes

Supplemental Life Insurance: Not applicable
Dependents Life Insurance: Yes
Accidental Death And Dismemberment
(AD&D) Insurance: Yes
Policyholder: Washington Nationals Baseball Club, LLC
Employer(s): Washington Nationals Baseball Club, LLC

Group Policy Effective Date: January 1, 2015
Policy Issued in: District of Columbia

BECOMING INSURED

To become insured for Life Insurance you must: (a) Be a Member; (b) Complete your Eligibility Waiting
Period; and (c) Meet the requirements in Life Insurance and Active Work Provisions. The requirements
for becoming insured for coverages other than Life Insurance are set out in the text.
Definition of Member: You are a Member if you are:
1. An active L.L.C. Owner-Employee or non-seasonal
employee of the Employer other than an employee
covered under the Major League Insurance Plan who
has a life benefit under the Plan of $80,000 or greater;
and
2. Regularly working at least 35 hours per week.

You are not a Member if you are:
1. A temporary or seasonal employee.

2. A leased employee.
3. An independent contractor.
4. A full time member of the armed forces of any country.
Class Definition:

Class 1: All eligible Members, excluding Members covered under the
Major League Baseball Benefit Plan or Minor League Health
& Welfare Plan

Revised 08/10/2021 - 1 - 151138-D