2. Revised 11-2014 Surency AdvantagePlus How To: Benefits Card

3. How To: Benefits Card Overview > > How To: Benefits Card Overview Where you can use your Surency AdvantagePlus Benefits Card How to use your benefits card Why your card may be declined When additional documentation may be needed o How you will be notified o How to submit documentation o When your card will be reinstated What information is required to be on additional documentation Revised 11-2014

4. Where you can use your benefits card > > Where you can use your benefits card Medical Providers Pharmacies Some retail and grocery stores Find a full list of retailers at www.SIGIS.com  The vendor you are purchasing from must have the correct inventory support system and credit card system in place in order to accept your benefits card. If the vendor does not have the correct system, your card will be declined. Revised 11-2014

5. How to use your benefits card > > How to use your benefits card 1. Ring up all items or services together 2. Swipe your benefits card and select ‘Credit’ Optional: You can set up a PIN to access your funds by calling 866.898.9795. If you have a PIN, select ‘debit’ and enter your PIN 3. Qualified medical purchases will be paid from your FSA, HRA or HSA and deducted from your total due 4. Use a second form of payment for the remaining non-medical items 5. Keep your receipt Revised 11-2014

6. Why your card may be declined > > Why your card may be declined  Non-PIN users: Selected ‘Debit’ instead of ‘Credit’  Not enough funds in your account  The vendor does not have the correct system in place to accept your card  Items are not qualified medical expenses  Over-the-Counter items require a prescription; vendor does not have ability to verify prescription  Expired card  Suspended card Revised 11-2014

7. When additional documentation is needed > > When additional documentation is needed How you will be notified: Email after card is used First Receipt Reminder Second and Final Receipt Reminder (28 days after first reminder) Claim Denial Notification (14 day after second reminder) Card suspended 14 days after Claim Denial Notification  Surency may need to collect additional documentation to verify your expense. This is why you should always keep your receipts, prescriptions and other documentation. How to submit documentation: Manually (fax) Online through the Member Login Online via the Mobile Application (FSA Only)  If your card is suspended, it will be reinstated when Surency receives valid documentation and verifies the purchase, when Surency receives a refund for the transaction amount or when you submit a claim with an eligible expense that will off-set the refund you owe Surency. Revised 11-2014

8. What should be included on documentation > > What should be included on documentation Name of the vendor or service provider Patient’s name (first and last) Description of service or product purchased o If card is used for co-pay, you must list the service Prescription drug number (if applicable) Date(s) of service or purchase Transaction amount  Your receipt, invoice, prescription or other documentation will only be valid if it includes:  Submit online through the Member Login at surency.com or by fax to 316-462-3342 Revised 11-2014

9. Surency AdvantagePlus Questions?  Get answers to your questions and more information: Call Customer Service at 866.818.8805 Visit www.surency.comwww.surency.com o FAQs o What to do if your card is declined o Full list of retail providers accepting your Surency AdvantagePlus Benefits Card Revised 11-2014