www.myaetnasupplemental.com
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Submitted URL: https://www.myaetnasupplemental.com/?cid=eml-1366694&sub=PQXH3QBBBPXZ
Effective URL: https://www.myaetnasupplemental.com/?cid=eml-1366694&sub=PQXH3QBBBPXZ
Submission: On September 15 via manual from US — Scanned from DE
Effective URL: https://www.myaetnasupplemental.com/?cid=eml-1366694&sub=PQXH3QBBBPXZ
Submission: On September 15 via manual from US — Scanned from DE
Form analysis 1 forms found in the DOM
POST /?cid=eml-1366694&sub=PQXH3QBBBPXZ
<form action="/?cid=eml-1366694&sub=PQXH3QBBBPXZ" method="post" novalidate="novalidate"><input name="__RequestVerificationToken" type="hidden" value="ytAFR3xFajLoLqe2lcNcuzWX0KlQWEGmjFMDlCWm7jVaPnRF5Pztc-QdxJJa3BJ4n7Cy5rKC4kfRNir0LLYYrQ68qY01">
<div id="divlogin" class="VolTopPaddingPer2 VolNoLeftPaddingMargin VolNoRightPaddingMargin">
<div class="panel panel-default ">
<div class="panel-heading VoluntaryBGColor VolWhiteColorFont text-center">
<h1 class="panel-title text-center VolPaddingLeft5"><span class="glyphicon glyphicon-user"></span><strong> </strong></h1>
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<div class="validation-summary-valid FormInputErrMsg help-block danger left" data-valmsg-summary="true">
<ul>
<li style="display:none"></li>
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<div class="panel-body">
<!-- User Name -->
<div class="form-group">
<label for="UserName">User name</label>
<input autocapitalize="off" class="form-control FormInputError VolGreyContainerBackground" data-val="true" data-val-required="Error: User name required" id="UserName" name="UserName" placeholder="User name" type="text" value="">
<span class="field-validation-valid FormInputErrMsg help-block msgUserName left danger" data-valmsg-for="UserName" data-valmsg-replace="true"></span>
</div>
<!-- Password -->
<div class="form-group">
<label for="volLoginPassword">Password</label>
<div class="input-group ">
<input autocomplete="off" class="form-control FormInputError VolElementHeightFixed34PX VolGreyContainerBackground" data-val="true" data-val-required="Error: Password required" id="volLoginPassword" name="Password" placeholder="Password"
type="password">
<span class="input-group-addon VolElementHeightFixed34PX">
<label>
<input type="checkbox" id="volLoginChkBoxShowPassword" style="vertical-align: sub" onkeypress="ShowHidePassword()" onclick="ShowHidePassword()">
<small>Show</small>
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<span class="field-validation-valid FormInputErrMsg help-block msgPassword left danger" data-valmsg-for="Password" data-valmsg-replace="true"></span>
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<!-- Remember Me -->
<div class="form-group">
<div class="row ">
<div class="col-xs-4 col-md-5 text-nowrap ">
<label for="RememberMe" class="text-nowrap ">
<input id="RememberMe" name="RememberMe" type="checkbox" value="true"><input name="RememberMe" type="hidden" value="false">
<small>Remember me</small>
</label>
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<div class="col-xs-8 col-md-7 text-right forUserNamePassword">
<p class="hidden-xs" style="font-weight:500"> Forgot <a href="#" class="btn-bootstrap-dialog VoluntaryColorTheme" tabindex="0" data-customurl="/Account/ForgotUser/" aria-label="Forgot user name">user name</a> or
<a href="#" class="btn-bootstrap-dialog VoluntaryColorTheme" tabindex="0" data-customurl="/Account/ForgotPassword/" aria-label="Forgot password">password</a>
</p>
<small class="visible-xs"> Forgot <a href="#" class="btn-bootstrap-dialog frgtUsername VoluntaryColorTheme" tabindex="0" data-customurl="/Account/ForgotUser/" aria-label="Forgot user name">user name</a> or
<a href="#" class="btn-bootstrap-dialog frgtPassword VoluntaryColorTheme" tabindex="0" data-customurl="/Account/ForgotPassword/" aria-label="Forgot password">password</a>
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<div class="form-group center-block ">
<input type="submit" name="btnSignIn" value="Sign In" id="btnSignIn" class="btn btn-primary btn-block VoluntaryBGColor round show-loading">
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<div id="loadingSection" class="hide loadinElement">
<i class="fa fa-refresh fa-spin fa-fw" aria-hidden="true"></i>
<span><strong>We are gathering your information...</strong></span>
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<div class="panel-footer">
<h4 class="VoluntaryColorTheme"><strong>First-time users</strong></h4>
<p> Please sign up for an account. <br> Select "Register Now" below to create a user name and password. </p>
<div class="form-group center-block ">
<button class="btn btn-primary btn-block VoluntaryBGColor round" id="btnVolRegisterNow" type="button" onclick="location.href = '/account/RegisterNow';"> Register Now </button>
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</div>
</div>
</div>
</div>
</form>Text Content
Here when you need us Contact Us Coronavirus Updates The most recent news and information about Coronavirus (COVID-19) Learn More * User name Password Show Remember me Forgot user name or password Forgot user name or password We are gathering your information... FIRST-TIME USERS Please sign up for an account. Select "Register Now" below to create a user name and password. Register Now 1. 2. 3. 4. 5. Notice regarding electronic documents: Through this website, you have the ability to view, print and save electronic documents. You also have the right to receive ... View more Through this website, you have the ability to view, print and save electronic documents. You also have the right to receive documents online only, without receiving paper copies through the mail. To do so, you must have a computer, mobile device (such as a smartphone), tablet or another electronic device to access the website. Aetna uses 128-bit encryption to enhance security. Adobe Acrobat® 4.0 software or higher is required to view and open documents online. You can also select "Contact Us" on the home page to send an email or call our customer service center. If you require assistance in a language other than English, Non-discrimination notice attached. TTY : 711 For ... View more If you require assistance in a language other than English, Non-discrimination notice attached. TTY : 711 For language assistance in your language call 1-888-772-9682 at no cost. (English) Para obtener asistencia lingüística en su idioma, llame sin cargo al 1-888-772-9682. (Spanish) Click here to view Non-discrimination notice. Accessibility Services Aetna strives to continuously improve our digital experiences to meet or exceed universal design best practices and web accessibility ... View more Aetna strives to continuously improve our digital experiences to meet or exceed universal design best practices and web accessibility standards. We have adopted Web Content Accessibility Guidelines (WCAG) 2.0 A/AA as our corporate standard. If you are having trouble accessing information on our website, we can assist you. Please call 1-888-772-9682. Relay services for deaf and hearing impaired individuals are available by dialing 711. Aetna complies with applicable Federal civil rights laws and does not discriminate, exclude or treat people differently based on their race, color, national origin, sex, age, or disability. Aetna provides free aids/services to people with disabilities and to people who need language assistance. If you need a qualified interpreter, written information in other formats, translation or other services, call 1-888-772-9682. Be sure to include your claim number and name. You'll also need to tell us what document you'd like our help with. Get more for less Enjoy 20% off eligible CVS Health® brand items to help you take better care of your health View more Enjoy 20% off eligible CVS Health® brand items to help you take better care of your health Click here to view eligible CVS Health® brand items Save on health and wellness products and services with Aetna® discounts View more Save on health and wellness products and services with Aetna® discounts Click here to view discounts 1. 2. 3. 4. 5. Notice regarding electronic documents: Through this website, you have the ability to view, print and save electronic documents. You also have the right to receive ... View more Through this website, you have the ability to view, print and save electronic documents. You also have the right to receive documents online only, without receiving paper copies through the mail. To do so, you must have a computer, mobile device (such as a smartphone), tablet or another electronic device to access the website. Aetna uses 128-bit encryption to enhance security. Adobe Acrobat® 4.0 software or higher is required to view and open documents online. You can also select "Contact Us" on the home page to send an email or call our customer service center. If you require assistance in a language other than English, Non-discrimination notice attached. TTY : 711 For ... View more If you require assistance in a language other than English, Non-discrimination notice attached. TTY : 711 For language assistance in your language call 1-888-772-9682 at no cost. (English) Para obtener asistencia lingüística en su idioma, llame sin cargo al 1-888-772-9682. (Spanish) Click here to view Non-discrimination notice. Accessibility Services Aetna strives to continuously improve our digital experiences to meet or exceed universal design best practices and web accessibility ... View more Aetna strives to continuously improve our digital experiences to meet or exceed universal design best practices and web accessibility standards. We have adopted Web Content Accessibility Guidelines (WCAG) 2.0 A/AA as our corporate standard. If you are having trouble accessing information on our website, we can assist you. Please call 1-888-772-9682. Relay services for deaf and hearing impaired individuals are available by dialing 711. Aetna complies with applicable Federal civil rights laws and does not discriminate, exclude or treat people differently based on their race, color, national origin, sex, age, or disability. Aetna provides free aids/services to people with disabilities and to people who need language assistance. If you need a qualified interpreter, written information in other formats, translation or other services, call 1-888-772-9682. Be sure to include your claim number and name. You'll also need to tell us what document you'd like our help with. Get more for less Enjoy 20% off eligible CVS Health® brand items to help you take better care of your health View more Enjoy 20% off eligible CVS Health® brand items to help you take better care of your health Click here to view eligible CVS Health® brand items Save on health and wellness products and services with Aetna® discounts View more Save on health and wellness products and services with Aetna® discounts Click here to view discounts BENEFITS OF VOLUNTARY PLANS * See your coverage and benefits * Get status of a claim * Electronically submit forms * Upload documents * Get documents and important forms * DocFind - Find an in-network provider PRINTABLE FORMS * Claim forms * Portability forms DOWNLOAD MY AETNA SUPPLEMENTAL APP Aetna is the brand name used for products and services provided by one or more of the Aetna group of subsidiary companies, including Aetna Life Insurance Company and its affiliates (Aetna). 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