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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 Di sclosures.  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 ineli gible, 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 t ax 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.  
<<DATA56>>  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 ma y 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:  
� Health Savings Account (HSA)  
� Flexible Spending Account (FSA)  
� Health Reimbursement Arrangement (HRA)  
� Dependent Care Account (DCA)  
� Transit/Parking Account  
 
Check  with Lane Health  for additio nal information regarding 
eligibility and the reimbursement process.   
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.  
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.