www.afenroll.com Open in urlscan Pro
206.127.26.89  Public Scan

Submitted URL: https://www.afenroll.com/Admin/report_myreports.aspx?RPTID=90427697
Effective URL: https://www.afenroll.com/admin/login.aspx?ReturnUrl=%2fAdmin%2freport_myreports.aspx%3fRPTID%3d90427697&RPTID=90427697
Submission: On May 16 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

POST ./login.aspx?ReturnUrl=%2fAdmin%2freport_myreports.aspx%3fRPTID%3d90427697&RPTID=90427697

<form method="post" action="./login.aspx?ReturnUrl=%2fAdmin%2freport_myreports.aspx%3fRPTID%3d90427697&amp;RPTID=90427697" id="login" autocomplete="off">
  <div class="aspNetHidden">
    <input type="hidden" name="timezone" id="timezone" value="-2">
    <input type="hidden" name="__EVENTTARGET" id="__EVENTTARGET" value="">
    <input type="hidden" name="__EVENTARGUMENT" id="__EVENTARGUMENT" value="">
    <input type="hidden" name="__VIEWSTATE" id="__VIEWSTATE" value="dSK0PjPREbnehjIZCR8geKEeujw7RSVknB8hMXSkLr60aKMYg9iVbfW2CzWOOLYfd33SgAT7BU6v3kjVW9NdnZmG7bTeLJfi5CAcJRdCOew=">
  </div>
  <script type="text/javascript">
    //<![CDATA[
    var theForm = document.forms['login'];
    if (!theForm) {
      theForm = document.login;
    }

    function __doPostBack(eventTarget, eventArgument) {
      if (!theForm.onsubmit || (theForm.onsubmit() != false)) {
        theForm.__EVENTTARGET.value = eventTarget;
        theForm.__EVENTARGUMENT.value = eventArgument;
        theForm.submit();
      }
    }
    //]]>
  </script>
  <div class="aspNetHidden">
    <input type="hidden" name="__VIEWSTATEGENERATOR" id="__VIEWSTATEGENERATOR" value="1D3207DC">
    <input type="hidden" name="__VIEWSTATEENCRYPTED" id="__VIEWSTATEENCRYPTED" value="">
    <input type="hidden" name="__EVENTVALIDATION" id="__EVENTVALIDATION"
      value="TudCV8tTi2SFTp+ETf1g06ZFUeOP2EacfjkeRQ7Z3etsAE81vJ+p9HCZ0pH8vfn7OQ2kCvEbEd/T2a0KwhDB23FR5l2PnLc8PERmaNbclIfApFU/t5BEh4zchQK+Xs35AfGpcPyTC65CV/MSbSWk3GYqsS22kXIqmhAZi/1F2YvwZ4gZiJOIR1yu44D9ef02ClhfibyHjhW0cDK++S3wvvpaw9e6Lqqon2avStSj98xpDeCFsiDDiDUnQMnmEeoKzetaoXNHSGGjXG1rj7cI6q6KivzFrgxqWNBzdJkv5rM=">
  </div>
  <input type="hidden" name="forgeryToken" id="forgeryToken" value="87b961b1-aa2f-4447-81b4-177c723a530b">
  <style type="text/css">
    body {
      padding: 0;
      background: #f2f2f2 url('lib/Images/AFEnrollBackground.png') top center no-repeat;
      color: #6e6d71;
      font-size: 20px;
    }

    a,
    a:active,
    a:visited {
      color: #eb0029;
      text-decoration: underline;
    }

    a:hover {
      color: #b90a17;
    }

    .centerBox {
      margin: 0;
      padding: 0;
      width: 100%;
      max-width: 100%;
      border: none;
    }

    .AFadmin-container {
      width: 550px;
      margin: 15px auto;
    }

    .AF-control-label {
      display: block;
      font-weight: bold;
    }

    .AF-input {
      width: 100%;
      margin-bottom: 30px;
      padding: 5px;
      font-size: 26px;
      border: 2px solid #b7b7b9;
      background: #fff;
      color: #6e6d71;
    }

    .AF-button {
      width: 100%;
      margin-bottom: 15px;
      padding: 5px;
      font-size: 26px;
      border: 2px solid #ea1d2c;
      background: #ea1d2c;
      color: #fff;
    }

    .AF-button:hover {
      background: #b90a17;
    }

    .AF-error {
      display: block;
      margin-bottom: 25px;
      color: #eb0029;
    }

    .AF-Logo {
      max-width: 493px;
    }

    #container {
      margin: 0;
      padding: 0;
      width: 100%;
      max-width: 100%;
      border: none;
    }

    #AF-header {
      margin-top: 100px;
      margin-bottom: 50px;
      text-align: center;
    }

    #AF-links {
      font-size: 20px;
      word-spacing: 8px;
      text-align: center;
    }

    #AF-adminlink {
      margin-top: 50px;
      color: #eb0029;
      text-align: center;
      font-size: 24px;
    }

    #AF-adminStatement {
      font-size: 18px;
      text-align: left;
    }

    #AF-footer {
      margin-top: 25px;
      width: 1370px;
      text-align: center;
    }

    #AF-footer-right {
      float: right;
      text-align: right;
      color: #000000;
    }

    #AF-footer-left {
      font-size: 24px;
      float: left;
    }
  </style>
  <div class="AFadmin-container" id="AF-header">
    <img src="lib/Images/AFEnroll.png" alt="AFenroll Administrative Site">
  </div>
  <div class="AFadmin-container" id="AFenroll-case-select">
  </div>
  <div class="AFadmin-container" id="AFEnroll-controls">
    <label for="LoginCtrl_txtUserName" id="LoginCtrl_lblUID" class="AF-control-label">User ID: </label>
    <input name="LoginCtrl$txtUserName" type="text" autocomplete="nope" id="LoginCtrl_txtUserName" tabindex="1" class="AF-input">
    <label for="LoginCtrl_txtPassword" id="LoginCtrl_lblPassword" class="AF-control-label">Password: </label>
    <input name="LoginCtrl$txtPassword" type="password" autocomplete="nope" id="LoginCtrl_txtPassword" tabindex="2" class="AF-input">
    <input type="submit" name="LoginCtrl$cmdLogon" value="Log in" id="LoginCtrl_cmdLogon" class="AF-button">
    <div id="AF-links">
      <a id="LoginCtrl_lnkResetPassword" lang="en" href="javascript:__doPostBack('LoginCtrl$lnkResetPassword','')">Forgot Password?</a> |
      <a href="#" id="securityInfoLink" data-toggle="modal" data-target="#security-information-dialog">Security Information</a> | <a href="#" id="privacyPolicyLink" data-toggle="modal" data-target="#privacy-policy-dialog">Privacy Policy</a>
    </div>
    <p class="p-3 gutter-top">By providing your user name and password, you are agreeing to the <a href="#" id="consentToEnrollLink" data-toggle="modal" data-target="#terms-of-use-dialog">Terms of Use Agreement</a>.</p>
    <!--
    <a id="LoginCtrl_lnkConsentToEnroll" lang="en" href="javascript:__doPostBack(&#39;LoginCtrl$lnkConsentToEnroll&#39;,&#39;&#39;)">Consent to Enroll Electronically</a>    
    <a id="LoginCtrl_lnkNewEmployee" lang="en" href="javascript:__doPostBack(&#39;LoginCtrl$lnkNewEmployee&#39;,&#39;&#39;)">New Employee? If so, click here</a>
    <a id="LoginCtrl_LanguageButton" lang="en" href="javascript:__doPostBack(&#39;LoginCtrl$LanguageButton&#39;,&#39;&#39;)">Haz clic aqu� para Espa�ol</a>
    -->
  </div>
  <div class="AFadmin-container" id="AF-adminlink"> Not an Administrative User? Try the <a id="LoginCtrl_lnkEnrollSite" lang="en" href="javascript:__doPostBack('LoginCtrl$lnkEnrollSite','')">Enrollment Site</a>
  </div>
  <div class="AFadmin-container" id="AF-adminStatement"> You must have a valid administrative user ID and password to access this website. If you do not yet have a user ID or you have difficulty logging in, please contact your system administrator.
    Unauthorized use is strictly prohibited. </div>
  <div class="AFadmin-container" id="AF-footer">
    <div id="AF-footer-left"> © American Fidelity Assurance Company. Portions © Selerix Systems, Inc. </div>
    <div id="AF-footer-right">
      <img src="lib/Images/AmericanFidelity.png" alt="American Fidelity" class="AF-Logo">
    </div>
  </div>
  <script type="text/javascript">
    $('#LoginCtrl_lnkEnrollSite').click(function() {
      location.href = '../enroll';
      return false;
    });
    $('#LoginCtrl_lnkResetPassword').click(function() {
      location.href = './open/resetpassword.aspx';
      return false;
    });
    $('#LoginCtrl_txtUserName').focus();
  </script>
  <div id="modals-vue">
    <div>
      <div>
        <div tabindex="-1" role="dialog" class="modal fade" id="security-information-dialog">
          <div role="document" class="modal-dialog modal-md">
            <div class="modal-content">
              <div class="modal-header bg-primary"><button type="button" data-dismiss="modal" aria-label="Close" class="close"><span aria-hidden="true" class="bg-primary">×</span></button>
                <h4 lang="" class="modal-title">Security Information</h4>
              </div>
              <div class="modal-body">
                <div></div>
              </div>
              <div class="modal-footer">
                <div class="pull-left"><span><a href="#" data-dismiss="modal" data-target="terms-of-use-dialog"><u>Terms of Use Agreement</u></a> <span> |
                    </span></span><span><a href="#" data-dismiss="modal" data-target="privacy-policy-dialog"><u>Privacy Policy</u></a> <span> |
                    </span></span><span><a href="#" data-dismiss="modal" data-target="hipaa-notice-dialog"><u>HIPAA Notice</u></a> <!----></span></div> <button type="button" data-dismiss="modal" class="btn btn-sm btn-default">OK</button>
              </div>
            </div>
          </div>
        </div>
      </div>
      <div>
        <div tabindex="-1" role="dialog" class="modal fade" id="privacy-policy-dialog">
          <div role="document" class="modal-dialog modal-md">
            <div class="modal-content">
              <div class="modal-header bg-primary"><button type="button" data-dismiss="modal" aria-label="Close" class="close"><span aria-hidden="true" class="bg-primary">×</span></button>
                <h4 lang="" class="modal-title">Privacy Policy</h4>
              </div>
              <div class="modal-body">
                <div></div>
              </div>
              <div class="modal-footer">
                <div class="pull-left"><span><a href="#" data-dismiss="modal" data-target="terms-of-use-dialog"><u>Terms of Use Agreement</u></a> <span> |
                    </span></span><span><a href="#" data-dismiss="modal" data-target="security-information-dialog"><u>Security Information</u></a> <span> |
                    </span></span><span><a href="#" data-dismiss="modal" data-target="hipaa-notice-dialog"><u>HIPAA Notice</u></a> <!----></span></div> <button type="button" data-dismiss="modal" class="btn btn-sm btn-default">OK</button>
              </div>
            </div>
          </div>
        </div>
      </div>
      <div>
        <div tabindex="-1" role="dialog" class="modal fade" id="terms-of-use-dialog">
          <div role="document" class="modal-dialog modal-md">
            <div class="modal-content">
              <div class="modal-header bg-primary"><button type="button" data-dismiss="modal" aria-label="Close" class="close"><span aria-hidden="true" class="bg-primary">×</span></button>
                <h4 lang="" class="modal-title">Terms of Use Agreement</h4>
              </div>
              <div class="modal-body">
                <div></div>
              </div>
              <div class="modal-footer">
                <div class="pull-left"><span><a href="#" data-dismiss="modal" data-target="privacy-policy-dialog"><u>Privacy Policy</u></a> <span> |
                    </span></span><span><a href="#" data-dismiss="modal" data-target="security-information-dialog"><u>Security Information</u></a> <span> |
                    </span></span><span><a href="#" data-dismiss="modal" data-target="hipaa-notice-dialog"><u>HIPAA Notice</u></a> <!----></span></div> <button type="button" data-dismiss="modal" class="btn btn-sm btn-default">OK</button>
              </div>
            </div>
          </div>
        </div>
      </div>
      <div>
        <div tabindex="-1" role="dialog" class="modal fade" id="hipaa-notice-dialog">
          <div role="document" class="modal-dialog modal-md">
            <div class="modal-content">
              <div class="modal-header bg-primary"><button type="button" data-dismiss="modal" aria-label="Close" class="close"><span aria-hidden="true" class="bg-primary">×</span></button>
                <h4 lang="" class="modal-title">HIPAA Notice</h4>
              </div>
              <div class="modal-body">
                <div></div>
              </div>
              <div class="modal-footer">
                <div class="pull-left"><span><a href="#" data-dismiss="modal" data-target="terms-of-use-dialog"><u>Terms of Use Agreement</u></a> <span> |
                    </span></span><span><a href="#" data-dismiss="modal" data-target="privacy-policy-dialog"><u>Privacy Policy</u></a> <span> |
                    </span></span><span><a href="#" data-dismiss="modal" data-target="security-information-dialog"><u>Security Information</u></a> <!----></span></div> <button type="button" data-dismiss="modal"
                  class="btn btn-sm btn-default">OK</button>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
  </div>
  <script type="text/javascript">
    require(['selerix_common/vues/pages/login/linked-modals/LinkedModals.vue'], function(LinkedModals) {
      LinkedModals.mount('#modals-vue', [{
        "id": "security-information-dialog",
        "title": "Security Information",
        "theme": "primary",
        "url": "security-information.html",
        "buttons": ["terms-of-use-dialog", "privacy-policy-dialog", "hipaa-notice-dialog"]
      }, {
        "id": "privacy-policy-dialog",
        "title": "Privacy Policy",
        "theme": "primary",
        "url": "privacy-policy.html",
        "buttons": ["terms-of-use-dialog", "security-information-dialog", "hipaa-notice-dialog"]
      }, {
        "id": "terms-of-use-dialog",
        "title": "Terms of Use Agreement",
        "theme": "primary",
        "url": "lib/AmericanFidelity/AF_admin_terms-of-use.html",
        "buttons": ["privacy-policy-dialog", "security-information-dialog", "hipaa-notice-dialog"]
      }, {
        "id": "hipaa-notice-dialog",
        "title": "HIPAA Notice",
        "theme": "primary",
        "url": "hipaa-notice.html",
        "buttons": ["terms-of-use-dialog", "privacy-policy-dialog", "security-information-dialog"]
      }]);
    });
  </script>
  <script type="text/javascript">
    //<![CDATA[
    selerix.selerixCommonPath = 'https://dxxqfq1r39oh3.cloudfront.net/admin/selerix_common';
    selerix.applicationRoot = './';
    selerix.requiredFieldError = 'Important: Please complete this required field';
    selerix.optionalFieldError = 'Important: Please complete this optional field or leave it empty';
    selerix.validatorSummary = 'Required information is missing or invalid.';
    selerix.textbank.handlerUrl = 'App_SelerixResource/Selerix.BenSelect.Web.dll/Selerix.BenSelect.Web.WebHandlers.TextBankEditorHandler.aspx';
    selerix.localization.languageId = 1;
    selerix.localization.languageDescription = 'English';
    selerix.caseUnLocked = '';
    selerix.console.loggingEnabled = false;
    jQuery(document).ready(function() {
      var current_date = new Date();
      var gmt_offset = current_date.getTimezoneOffset() / 60;
      var tmzInput = jQuery('#timezone');
      tmzInput.val(gmt_offset);
      selerix.session.prepLogin();
    });
    Page_BusyBox = new ProcessingBox("Processing");
    Page_BusyBox.Enabled = true;
    $(function() {
      initializeLocalizationPage();
    });
    $(function() {
      initializeFormPage();
    });
    Page_Validators = new Array;
    Silverlight_Apps = new Array;
    $('#modalErrorMessage').val('');
    $('#modalErrorMessageCancel').val('');
    $(function() {
      if (!window.navigator.onLine) {
        alert(ErrorMsg("ERR:0021"));
      }
      if ($('#modalErrorMessage').length && $('#modalErrorMessage').val().length) {
        setTimeout("showStatusMessageBox($('#modalErrorMessage').val(), false, ''); $('#modalErrorMessage').val('');", 100);
      } else if ($('#modalErrorMessageCancel').length && $('#modalErrorMessageCancel').val().length) {
        setTimeout("showStatusMessageBox($('#modalErrorMessageCancel').val(), true, ''); $('#modalErrorMessageCancel').val('');", 100);
      }
      if (window.Page_ValidationErrors !== void 0 && window.Page_ValidationErrors !== null && window.Page_ValidationErrors.length > 0) ShowSummary(Page_ValidationErrors, false, null, false);
      Page_ValidationActive = false;
      if (Page_DomValidationVer === void 0) alert("Unknown DOM validation version");
      else ValidatorOnLoad();
      prepareForm();
    }); // End DOM ready
    selerix.globals.setSiteStyle('');
    selerix.globals.siteTheme = ''
    selerix.globals.isLaptop = 'false' == 'true';
    selerix.globals.textBankAutoPost = function() {
      setTimeout('__doPostBack(\'__Page\',\'TextBank\')', 0)
    };
    $(function() {
      postInitializeLocalizationPage();
    });
    //]]>
  </script>
</form>

Text Content

User ID: Password:
Forgot Password? | Security Information | Privacy Policy

By providing your user name and password, you are agreeing to the Terms of Use
Agreement.

Not an Administrative User? Try the Enrollment Site
You must have a valid administrative user ID and password to access this
website. If you do not yet have a user ID or you have difficulty logging in,
please contact your system administrator. Unauthorized use is strictly
prohibited.
© American Fidelity Assurance Company. Portions © Selerix Systems, Inc.

×

SECURITY INFORMATION


Terms of Use Agreement | Privacy Policy | HIPAA Notice
OK
×

PRIVACY POLICY


Terms of Use Agreement | Security Information | HIPAA Notice
OK
×

TERMS OF USE AGREEMENT


Privacy Policy | Security Information | HIPAA Notice
OK
×

HIPAA NOTICE


Terms of Use Agreement | Privacy Policy | Security Information
OK