www.afenroll.com
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206.127.26.89
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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
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 DOMPOST ./login.aspx?ReturnUrl=%2fAdmin%2freport_myreports.aspx%3fRPTID%3d90427697&RPTID=90427697
<form method="post" action="./login.aspx?ReturnUrl=%2fAdmin%2freport_myreports.aspx%3fRPTID%3d90427697&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('LoginCtrl$lnkConsentToEnroll','')">Consent to Enroll Electronically</a>
<a id="LoginCtrl_lnkNewEmployee" lang="en" href="javascript:__doPostBack('LoginCtrl$lnkNewEmployee','')">New Employee? If so, click here</a>
<a id="LoginCtrl_LanguageButton" lang="en" href="javascript:__doPostBack('LoginCtrl$LanguageButton','')">Haz clic aqu� para Espa�ol</a>
-->
</div>
<div class="AFadmin-container" id="AF-adminlink"> Not an Administrative User? Try the <a id="LoginCtrl_lnkEnrollSite" lang="en" href="javascript:__doPostBack('LoginCtrl$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