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WELCOME  TO  LANE  HEALTH  and  THE  CARD  WITH  A 
HEART! 
We  are  pleased  to  serve  your  benefits  spending  accounts 
needs.  Your  Debit  Mastercard  is  provided  to  you  by  your 
Employer  under  a  benefit  plan  allowed  by  the  IRS  and/or  in 
conjunction with a benefits spending account you established. 

USING YOUR CARD 
You may use the card at qualified locations such as hospitals, 
doctor’s  and  dentist’s  offices,  vision  services 
locations, 
pharmacies, day care facilities, and parking and mass transit 
providers  for  eligible  expenditures  under  your  Employer’s 
Benefit Plan. 

Your card will be linked to all the spending accounts you signed 
up for: 

Flexible Spending Account (FSA) 

•  Health Savings Account (HSA) 
• 
•  Health Reimbursement Arrangement (HRA) 
•  Dependent Care Account (DCA) 
• 

Transit/Parking Account 

Check  with  Lane  Health  for  additional  information  regarding 
eligibility and the reimbursement process. 

The  Lane  Health  Benefits  Debit  Mastercard(R)  is  issued  by  The  Bancorp  Bank, 
Member  FDIC,  pursuant  to  license  by  Mastercard  International  Incorporated. 
Mastercard  is  a  registered  trademark,  and  the  circles  design  is  a  trademark  of 
Mastercard International Incorporated. The Bancorp Bank is not affiliated in any way 
with your  benefit  plan  and/or  plan  documents, and does  not  endorse, sponsor or 
administer your benefit plan. 
This card cannot be used everywhere Debit Mastercard, Maestro and NYCE cards 
are accepted. This card cannot be  used at any ATM or to obtain cash. See your 
benefit plan documents for details. 

Your debit card will be automatically activated and 
you accept Lane Health’s Terms of Use the first 
time you use your debit card to pay a qualified 
healthcare expense.  See the Terms of Use at 
www.lanehealth.com. 

However, you must separately activate the 
Advance line of credit feature as described below. 

ADVANCE1 LINE OF CREDIT AND ACTIVATION 
Lane Health offers an optional Advance line of credit that allows 
you to pay healthcare expenses when you don’t have enough 
funds in your spending account to cover the bill.  Log in to the 
Lane  Health  member  portal  for  the  Advance  Terms  & 
Conditions and Disclosures.  You must activate your Advance 
line of credit by registering on the Lane Health member portal 
at  BeWell.lanehealth.com  or  by  calling  us  (833)  302-5263.  
Advances are issued by WebBank, Member FDIC. 

HOW TO USE YOUR BENEFITS DEBIT CARD 

1.  Read the front and back of this form carefully, record 
your card number on this form, and keep it in a safe 
place. 

2.  Sign the back of your card. 
3.  At the checkout terminal, if you are offered a choice, 
select “CREDIT” so you will be given a receipt to sign.  
If you are prompted for a PIN and you don’t have it, 
ask  the  merchant  to  process  the  transaction  so  you 
can sign the receipt instead.  To create a PIN, please 
log in to your account at BeWell.lanehealth.com. 
4.  Retain all your receipts.  You may be required by Lane 
Health,  your  Employer,  or  for  your  HSA,  the  IRS  to 
submit  your  receipts  to  document  that  the  purchase 
was for an eligible item under your Benefit Plan and 
applicable IRS regulations. 
Failure to submit receipts may result in: 

a)  The  expense  being  deemed  ineligible,  in  which 
case you would be obligated to repay the amount 
to the Benefit Plan; and/or 

b)  Suspension of your benefits card; and/or 
c)  Taxable  payroll  deductions  by your  Employer for 

the ineligible expense; and/or 

d)  Taxable income being subject to additional tax on 

the amount. 

5.  Visit  www.lanehealth.com 

to  obtain  up-to-date 

account balance and other information. 

Please visit www.lanehealth.com or call Lane Health 
at the number below to report your card lost or stolen. 
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