Part-Time Service Representative

E-Sign Disclosure Version *.*

Account Disclosures can be provided in electronic form for the benefit saving and spending account(s) (the Account or the Accounts, as applicable), whether Flexible Spending Account(s)

(FSA),the Health Savings Account (HSA) account(s), Health Reimbursement Arrangement

(HRA), Lifestyle Spending Account (LSA), and/or Medical Travel Account (MTA) (Account) you have selected to be opened online. Before obtaining products or services electronically, you must read and indicate your acceptance of the terms outlined below. If you do not consent, you will not be able to proceed with the online account opening process. 1. In this consent "we", "us", and "our" are used to refer to Lively, Inc., as well as, in the case of the HSA, the Financial Institution indicated on the Custodial Booklet included in the Terms and Conditions of Your Account Agreement. All of the disclosures being provided to you may, at our discretion, be in electronic form, and you will be able to review them online in addition to downloading and/or printing them. Your consent applies only to the disclosures and notices applicable to the Account opened during this online session. 2. Disclosures provided in electronic form will not be distributed in paper form. 3. You have the right to withdraw your consent at any time, at no cost to you, by notifying us at *******@********.***, updating your contact information within the Lively online application at https://livelyme.com, by calling us at 1-888-***-****, or by writing to us at 77 Geary Street, 5th Floor, San Francisco, CA 94108. In the event you withdraw your consent, we may at our sole discretion choose to close your Account(s).

4. By consenting to receive disclosures and notices electronically, you agree to provide us with the information (such as current email address) necessary to communicate with you electronically. You are required to update us with any changes in such information by notifying us at *******@********.***, updating your contact information within the Lively online application at https://livelyme.com, or by calling us at 1-888-***-****. 5. The following lists the hardware and software requirements necessary for access to and retention of the information being provided to you in electronic form. By consenting to receive the disclosures online, you will also be verifying you meet the necessary hardware and software requirements to view the disclosures. A personal computer or other device capable of accessing the internet and a web browser which supports 128bit SSL encrypted communications Software that permits you to receive and access Portable Document Format (PDF) files, such as Adobe Acrobat Reader version 5.1 or higher (available for downloading at http://get.adobe.com/reader/).