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account.bcbsil.com Open in urlscan Pro
104.126.37.178  Public Scan

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Submitted URL: https://links.mkt2527.com/els/v2/~mqbM0Gd6ks8m/RnNoempmbG5LSHZiSzVJazAvbGhZM2VpN1RuN0tZSnlvZjBoRnhyZXNsQVBURUJEWGV2K051ek9...
Effective URL: https://account.bcbsil.com/upp/
Submission: On May 20 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

#

<form action="#">
  <div class="mt-6">
    <div class="mt-6">
      <div class="flex items-center"><label for="firstName" class="fiber_label_30e4676d"><span
            class="fiber_text_b06ad8fb fiber_text_Size2_b06ad8fb fiber_text_ColorTextDark_b06ad8fb fiber_text_WeightBold_b06ad8fb fiber_text_StyleNormal_b06ad8fb fiber_taLeft_22dc9e15"><span class="email-field">First Name</span></span></label></div>
      <span class="fiber_input_c26a2848"><input class="fiber_input__input_c26a2848" name="firstName" type="string" id="firstName" data-testid="member-first-name" maxlength="1000" aria-invalid="false" aria-labelledby="firstName-error" value=""
          data-di-id="#firstName"></span>
      <div id="firstName-error"></div>
    </div>
  </div>
  <div class="mt-6">
    <div class="mt-6">
      <div class="flex items-center"><label for="lastName" class="fiber_label_30e4676d"><span
            class="fiber_text_b06ad8fb fiber_text_Size2_b06ad8fb fiber_text_ColorTextDark_b06ad8fb fiber_text_WeightBold_b06ad8fb fiber_text_StyleNormal_b06ad8fb fiber_taLeft_22dc9e15"><span class="email-field">Last Name</span></span></label></div>
      <span class="fiber_input_c26a2848"><input class="fiber_input__input_c26a2848" name="lastName" type="string" id="lastName" data-testid="member-last-name" maxlength="1000" aria-invalid="false" aria-labelledby="lastName-error" value=""
          data-di-id="#lastName"></span>
      <div id="lastName-error"></div>
    </div>
  </div>
  <div class="mt-6">
    <div class="mt-6">
      <div class="flex items-center"><label for="dateOfBirth" class="fiber_label_30e4676d"><span
            class="fiber_text_b06ad8fb fiber_text_Size2_b06ad8fb fiber_text_ColorTextDark_b06ad8fb fiber_text_WeightBold_b06ad8fb fiber_text_StyleNormal_b06ad8fb fiber_taLeft_22dc9e15"><span class="email-field">Date Of Birth</span></span></label>
      </div><span class="fiber_input_c26a2848"><input class="fiber_input__input_c26a2848" name="dateOfBirth" type="text" id="dateOfBirth" data-testid="member-date-of-birth" maxlength="14" placeholder="MM&nbsp;/&nbsp;DD&nbsp;/&nbsp;YYYY"
          aria-invalid="false" aria-labelledby="dateOfBirth-error" value="" data-di-id="#dateOfBirth"></span>
      <div id="dateOfBirth-error"></div>
    </div>
  </div>
  <div class="bcbs-member-id mt-6">
    <div class="flex items-center">
      <h2 class="heading-2">Member ID Number</h2><button class="fiber_iconButton_a842c970" type="button" data-testid="information" data-di-id="di-id-abccd9dc-68009163"><span
          class="fiber_icon_dd0fc6a6 fiber_icon_SizeInherit_dd0fc6a6 fiber_icon_ColorBlack_dd0fc6a6"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24" xml:space="preserve" fill="currentColor" role="img" aria-hidden="true" focusable="false"
            data-di-res-id="62ee71b6-60b74412" data-di-rand="1716229023285">
            <path d="M12 2C6.5 2 2 6.5 2 12s4.5 10 10 10 10-4.5 10-10S17.5 2 12 2zm0 18.5c-4.7 0-8.5-3.8-8.5-8.5S7.3 3.5 12 3.5s8.5 3.8 8.5 8.5-3.8 8.5-8.5 8.5z"></path>
            <path d="M13 9.5H9.2V11h2.3v5.5H9.2V18h6v-1.5H13z"></path>
            <ellipse cx="12.3" cy="7.2" rx="0.9" ry="1"></ellipse>
          </svg></span><span class="fiber_iconButton__srOnly_a842c970">Member card information</span></button>
    </div>
    <div class="flex"><img class="mr-2 bcbs-memmber-icon hidden md:block"
        src="data:image/svg+xml;base64,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"
        alt="member-id-icon">
      <div style="width: 100%;"><span class="fiber_input_c26a2848"><input class="fiber_input__input_c26a2848" name="memberId" id="memberId" data-testid="memberId-input" aria-label="memberId-input" value="" data-di-id="#memberId"
            style="letter-spacing: 0.2rem; font-size: 1.2rem; padding: 5px 1rem;"></span></div>
    </div>
  </div>
  <div class="communication-preference mt-8"><label class="fiber_checkbox_ded49b71"><input type="checkbox" name="communicationPreferences" data-testid="communicationPreferences"><span
        class="fiber_checkbox__label_ded49b71 fiber_checkbox__label_Left_ded49b71"><span
          class="fiber_text_b06ad8fb fiber_text_Size2_b06ad8fb fiber_text_ColorTextDark_b06ad8fb fiber_text_WeightNormal_b06ad8fb fiber_text_StyleNormal_b06ad8fb fiber_taLeft_22dc9e15 fiber_mt0_22dc9e15 fiber_mb0_22dc9e15 fiber_mr3_22dc9e15 fiber_ml3_22dc9e15">
          <div class="sm:flex sm:flex-col"><span>I agree with the Communication Preferences </span><span class="communication-preference-privacy-statement" data-testid="communication-preference-privacy-statement">Privacy Statement</span></div>
        </span></span></label></div>
  <div class="flex mt-16 sm:justify-start xs:flex-row-reverse"><button class="fiber_button_8d86c930 fiber_button_Size2_8d86c930 fiber_button_Primary_8d86c930" type="submit" data-testid="logInButton" disabled=""
      data-di-id="di-id-7b109a2d-8966f69f"><span class="fiber_icon_dd0fc6a6 fiber_icon_Size2_dd0fc6a6"><svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 32 32" xml:space="preserve" fill="currentColor" role="img" aria-hidden="true"
          focusable="false" data-di-res-id="62ee71b6-f38a033" data-di-rand="1716229023285">
          <path
            d="M25 15h-1v-5c0-2.8-1.4-5.4-4-6.9-1.3-.8-2.6-1.1-4-1.1-2.8 0-5.5 1.4-6.9 4C8.3 7.3 8 8.6 8 10v5H7c-1.7 0-3 1.3-3 3v9c0 1.7 1.3 3 3 3h18c1.7 0 3-1.3 3-3v-9c0-1.7-1.3-3-3-3zm-15-3v-2c0-1.1.3-2.1.8-3 1.1-1.9 3.1-3 5.2-3 1 0 2.1.3 3 .8 1.8 1.1 3 3.1 3 5.2v5H10v-3z">
          </path>
        </svg></span><span class="fiber_button__text_8d86c930">Log In</span></button></div>
</form>

Text Content

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First Name

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