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Is it only playable with sleeves (requiring you to pull it out and flip it over)

If it does, the ability triggers and goes on the stack

Ashiok only started to become popular after the same Pro Tour that Vein Ripper won

There's another very important aspect to mention about Muldrotha, but it's best explained with a full 99, so let's check out a decklist

That's what the default is

While this ability is well worth Teysa's spot as one's commander, this card works quite well with death triggers that create tokens, as Teysa has an additional ability that provides creature tokens under its owner's control with vigilance and lifelink.