onlineportal.aca-services.com Open in urlscan Pro
129.213.191.9  Public Scan

URL: https://onlineportal.aca-services.com/
Submission: On October 31 via automatic, source certstream-suspicious — Scanned from DE

Form analysis 1 forms found in the DOM

POST /

<form action="/" autocomplete="off" id="SignInForm" method="post" novalidate="novalidate">
  <div id="troublesigin"></div>
  <div id="siginDetailsDiv">
    <h1 class="h4 text-center font-adventor">Access your ACA forms online</h1>
    <p class="text-center small">You will receive a One Time Access (OTA) code to the below email address.</p>
    <div class="mb-3">
      <label for="EmailAddress" class="form-label mb-0 font-adventor">Email Address</label> <small class="text-muted d-block mb-2">Enter your email address where you received the online access link</small>
      <div class="input-group">
        <span class="input-group-text pt-2 position-absolute bg-transparent border-0 z-index-popover" id="addon-wrapping">
          <svg xmlns="http://www.w3.org/2000/svg" height="24px" viewBox="0 0 24 24" width="24px" fill="#000000">
            <path d="M0 0h24v24H0V0z" fill="none"></path>
            <path d="M22 6c0-1.1-.9-2-2-2H4c-1.1 0-2 .9-2 2v12c0 1.1.9 2 2 2h16c1.1 0 2-.9 2-2V6zm-2 0l-8 4.99L4 6h16zm0 12H4V8l8 5 8-5v10z" fill="#989898" class="fill"></path>
          </svg>
        </span> <input class="form-control ps-5" id="loginEmailAddress" maxlength="50" name="EmailAddress" placeholder="Email Address" tabindex="1" type="text" value="">
      </div>
    </div>
    <div class="mb-3">
      <label for="SSN" class="form-label mb-0 font-adventor">Last 4 digits of SSN</label> <small class="text-muted d-block mb-2">Enter the last 4 digits of your SSN</small>
      <div class="input-group">
        <span class="input-group-text pt-2 position-absolute bg-transparent border-0 z-index-popover" id="addon-wrapping">
          <svg xmlns="http://www.w3.org/2000/svg" height="24px" viewBox="0 0 24 24" width="24px" fill="#000000" onclick="showPassword()">
            <path d="M0 0h24v24H0V0z" fill="none"></path>
            <path
              d="M12 6c3.79 0 7.17 2.13 8.82 5.5C19.17 14.87 15.79 17 12 17s-7.17-2.13-8.82-5.5C4.83 8.13 8.21 6 12 6m0-2C7 4 2.73 7.11 1 11.5 2.73 15.89 7 19 12 19s9.27-3.11 11-7.5C21.27 7.11 17 4 12 4zm0 5c1.38 0 2.5 1.12 2.5 2.5S13.38 14 12 14s-2.5-1.12-2.5-2.5S10.62 9 12 9m0-2c-2.48 0-4.5 2.02-4.5 4.5S9.52 16 12 16s4.5-2.02 4.5-4.5S14.48 7 12 7z"
              fill="#989898" class="fill"></path>
          </svg>
        </span> <input class="form-control ps-5" id="loginSSN" maxlength="4" name="SSN" onkeypress="return isNumber(event)" pattern="^[0-9]*$" placeholder="Enter last 4 digits of SSN" tabindex="2" type="password" value="">
      </div>
    </div>
    <div class="text-center my-3">
      <button data-bb-handler="delete" type="button" class="btn bg-secondary text-white fw-bold px-3 rounded" onclick="ContinuetoOTP()" id="continuetoLoginbtn">Continue <span class="spinner-border spinner-border-sm" role="status" aria-hidden="true"
          id="continuetoLoginspinner" style="display:none;"></span></button>
      <ul class="list-unstyled mt-3 p-3 rounded shadow-sm  w-100 bottom-0 start-0 bg-light_1 d-lg-none text-start">
        <li class="d-flex mb-2">
          <div class="pe-2">
            <svg xmlns="http://www.w3.org/2000/svg" height="24" width="24">
              <path
                d="M12 22q-2.075 0-3.9-.788-1.825-.787-3.175-2.137-1.35-1.35-2.137-3.175Q2 14.075 2 12t.788-3.9q.787-1.825 2.137-3.175 1.35-1.35 3.175-2.138Q9.925 2 12 2q1.625 0 3.075.475 1.45.475 2.675 1.325L16.3 5.275q-.95-.6-2.025-.938Q13.2 4 12 4 8.675 4 6.338 6.337 4 8.675 4 12t2.338 5.663Q8.675 20 12 20q3.325 0 5.663-2.337Q20 15.325 20 12q0-.45-.05-.9t-.15-.875L21.425 8.6q.275.8.425 1.65.15.85.15 1.75 0 2.075-.788 3.9-.787 1.825-2.137 3.175-1.35 1.35-3.175 2.137Q14.075 22 12 22Zm-1.4-5.4-4.25-4.25 1.4-1.4 2.85 2.85 10-10.025 1.4 1.4Z">
              </path>
            </svg>
          </div> This secure portal enables you to view and download your ACA Forms 1095-B/1095-C/MA1099-HC at any time
        </li>
        <li class="d-flex text-dark">
          <div class="pe-2 ">
            <svg xmlns="http://www.w3.org/2000/svg" height="24" width="24">
              <path
                d="M12 22q-2.075 0-3.9-.788-1.825-.787-3.175-2.137-1.35-1.35-2.137-3.175Q2 14.075 2 12t.788-3.9q.787-1.825 2.137-3.175 1.35-1.35 3.175-2.138Q9.925 2 12 2q1.625 0 3.075.475 1.45.475 2.675 1.325L16.3 5.275q-.95-.6-2.025-.938Q13.2 4 12 4 8.675 4 6.338 6.337 4 8.675 4 12t2.338 5.663Q8.675 20 12 20q3.325 0 5.663-2.337Q20 15.325 20 12q0-.45-.05-.9t-.15-.875L21.425 8.6q.275.8.425 1.65.15.85.15 1.75 0 2.075-.788 3.9-.787 1.825-2.137 3.175-1.35 1.35-3.175 2.137Q14.075 22 12 22Zm-1.4-5.4-4.25-4.25 1.4-1.4 2.85 2.85 10-10.025 1.4 1.4Z">
              </path>
            </svg>
          </div> You will receive email notifications if your employer files any corrections to your ACA Forms
        </li>
      </ul>
    </div>
  </div>
  <div id="generateOtp" style="display:none">
    <h1 class="h4 text-center font-adventor">Access your ACA forms online</h1>
    <p class="text-center small">We have sent the One Time Access Code(OTA) to your email address</p>
    <div class=" text-center ">
      <label for="OTP" class="form-label mb-0 font-adventor">One Time Access (OTA) Code:</label> <small class="text-muted mb-2 d-block">To verify, enter the One Time Access Code below </small>
      <div class="input-group">
        <span class="input-group-text pt-2 position-absolute bg-transparent border-0 z-index-popover" id="addon-wrapping">
          <svg xmlns="http://www.w3.org/2000/svg" height="24px" viewBox="0 0 24 24" width="24px" fill="#000000">
            <path d="M0 0h24v24H0V0z" fill="none"></path>
            <path
              d="M12 6c3.79 0 7.17 2.13 8.82 5.5C19.17 14.87 15.79 17 12 17s-7.17-2.13-8.82-5.5C4.83 8.13 8.21 6 12 6m0-2C7 4 2.73 7.11 1 11.5 2.73 15.89 7 19 12 19s9.27-3.11 11-7.5C21.27 7.11 17 4 12 4zm0 5c1.38 0 2.5 1.12 2.5 2.5S13.38 14 12 14s-2.5-1.12-2.5-2.5S10.62 9 12 9m0-2c-2.48 0-4.5 2.02-4.5 4.5S9.52 16 12 16s4.5-2.02 4.5-4.5S14.48 7 12 7z"
              fill="#989898" class="fill"></path>
          </svg>
        </span>
        <input class="form-control ps-5" id="OneTimeAccessCode" maxlength="6" name="OTP" placeholder="One Time Access Code" type="text" value="">
      </div>
    </div>
    <div class="text-center mb-3 mt-2 small text-muted"> Didn't receive a code? <a class="text-center fw-500 text-danger" onclick="SendOTAByEmail(true,'')" id="resendloginOTAbtn">Resend </a>
      <span id="btnLoginEmailText"> (in <span id="txtLoginEmailResend">47</span>) seconds.</span>
    </div>
    <div class="text-center">
      <button type="button" class="btn bg-secondary text-white fw-bold px-2  rounded" onclick="CheckOTA()" id="submitloginOTAbtn">Submit <span class="spinner-border spinner-border-sm" role="status" aria-hidden="true" id="submitloginOTAbtnspinner"
          style="display:none;"></span></button>
    </div>
  </div>
  <div id="recoveryEmailandPhoneNumber" style="display:none">
    <div>
      <p class="fw-bold h6 mb-3">Set up Recovery Email Address and Phone Number</p>
      <p class="small mb-1">Adding a recovery phone number and email address will allow you to easily recover your account if you forget your credentials</p>
      <p class="small">You can select, skip for now if you would prefer to add this information later.</p>
      <div>
        <div class=" my-3 align-items-center justify-content-between card flex-row p-3 shadow border-0" id="beforeEditrecoveryEmailAddress" style="display:none">
          <div class="d-flex align-items-center">
            <div class="me-2 d-none d-md-block">
              <div class="d-flex justify-content-center align-items-center border  rounded-circle p-1">
                <svg xmlns="http://www.w3.org/2000/svg" height="40" width="40">
                  <path
                    d="M6.333 33.375q-1.208 0-2.104-.896-.896-.896-.896-2.146V9.667q0-1.25.896-2.146.896-.896 2.104-.896h27.334q1.208 0 2.104.896.896.896.896 2.146v20.666q0 1.25-.896 2.146-.896.896-2.104.896ZM20 21.292 6.333 12.417v17.916h27.334V12.417Zm0-2.875 13.5-8.75h-27Zm-13.667-6v-2.75 20.666Z"
                    fill="#999"></path>
                </svg>
              </div>
            </div>
            <div class="d-flex align-items-center flex-column flex-md-row">
              <p class="mb-0"><b>Step 1:</b><br> <small>Set Recovery Email Address </small></p>
            </div>
          </div>
          <div class="text-center my-2 ps-md-4">
            <a href="javascript:void(0)" data-bb-handler="delete" class="w-500 fw-bold px-3 rounded text-nowrap small-sm" data-bs-toggle="modal" onclick="addRecoveryEmaillAddress()">Add Email Address</a>
          </div>
        </div>
        <div class=" my-3  align-items-center justify-content-between card flex-row p-3 shadow border-0" id="afterEditrecoveryEmailAddress" style="display:none">
          <div class="d-flex align-items-center w-100">
            <div class="me-2 d-none d-md-block">
              <div class="d-flex justify-content-center align-items-center border  rounded-circle p-1 w-100">
                <svg xmlns="http://www.w3.org/2000/svg" height="40" width="40">
                  <path
                    d="M6.333 33.375q-1.208 0-2.104-.896-.896-.896-.896-2.146V9.667q0-1.25.896-2.146.896-.896 2.104-.896h27.334q1.208 0 2.104.896.896.896.896 2.146v20.666q0 1.25-.896 2.146-.896.896-2.104.896ZM20 21.292 6.333 12.417v17.916h27.334V12.417Zm0-2.875 13.5-8.75h-27Zm-13.667-6v-2.75 20.666Z"
                    fill="#989898"></path>
                </svg>
              </div>
            </div>
            <div class="d-flex align-items-center flex-column flex-md-row w-100">
              <p class="mb-0" id="viewemailrecoverystep"><b>Step 1:</b><br> <small>Recovery Email Address </small></p>
              <div class="d-flex align-content-center w-100 justify-content-between" id="viewemailrecovery">
                <div><label class="fw-bold d-block small-sm">Email Address</label><label id="UpdatedRecoveryEmailAddress"></label></div>
                <a onclick="EdidRecoveryEmailAddress()">
                                                    <div class="d-flex justify-content-center align-items-center border boreder-danger  rounded-circle p-1">

                                                        <svg xmlns="http://www.w3.org/2000/svg" height="24" width="24"><path d="m10 21 4-4h8v4Zm-6-2h1.4l8.625-8.625-1.4-1.4L4 17.6ZM18.3 8.925l-4.25-4.2 1.4-1.4q.575-.575 1.413-.575.837 0 1.412.575l1.4 1.4q.575.575.6 1.388.025.812-.55 1.387ZM16.85 10.4 6.25 21H2v-4.25l10.6-10.6Zm-3.525-.725-.7-.7 1.4 1.4Z" fill="#989898"></path></svg>

                                                    </div>
                                                </a>
              </div>
            </div>
          </div>
        </div>
        <div class=" my-3  align-items-center justify-content-between card flex-row p-3 shadow border-0" id="beforeEditrecoveryPhonrNumber" style="display:none">
          <div class="d-flex align-items-center">
            <div class="me-2  d-none d-md-block">
              <div class="d-flex justify-content-center align-items-center border  rounded-circle p-2">
                <svg xmlns="http://www.w3.org/2000/svg" height="40" width="40">
                  <path
                    d="M11.333 38.292q-1.25 0-2.145-.875-.896-.875-.896-2.125V4.708q0-1.25.896-2.125.895-.875 2.145-.875h17.334q1.25 0 2.145.875.896.875.896 2.125v30.584q0 1.25-.896 2.125-.895.875-2.145.875Zm0-7.167v4.167h17.334v-4.167ZM20 34.583q.583 0 .979-.395.396-.396.396-.98 0-.583-.396-.979T20 31.833q-.583 0-.979.396t-.396.979q0 .584.396.98.396.395.979.395ZM11.333 28.5h17.334V8.792H11.333Zm0-22.333h17.334V4.708H11.333Zm0 24.958v4.167Zm0-24.958V4.708v1.459Z"
                    fill="#989898"></path>
                </svg>
              </div>
            </div>
            <div class="d-flex align-items-center flex-column flex-md-row">
              <p class="mb-0"><b>Step 2:</b><br> <small>Set Recovery Phone Number </small></p>
            </div>
          </div>
          <div class="text-center my-2 ps-md-4">
            <a href="javascript:void(0)" data-bb-handler="delete" class="w-500 fw-bold px-3 rounded text-nowrap small-sm" data-bs-toggle="modal" onclick="addRecoveryPhoneNumber()">Add Phone Number</a>
          </div>
        </div>
        <div class=" my-3 align-items-center justify-content-between card flex-row p-3 shadow border-0" id="afterEditrecoveryPhonrNumber" style="display:none">
          <div class="d-flex align-items-center w-100">
            <div class="me-2  d-none d-md-block">
              <div class="d-flex justify-content-center align-items-center border  rounded-circle p-2">
                <svg xmlns="http://www.w3.org/2000/svg" height="40" width="40">
                  <path
                    d="M11.333 38.292q-1.25 0-2.145-.875-.896-.875-.896-2.125V4.708q0-1.25.896-2.125.895-.875 2.145-.875h17.334q1.25 0 2.145.875.896.875.896 2.125v30.584q0 1.25-.896 2.125-.895.875-2.145.875Zm0-7.167v4.167h17.334v-4.167ZM20 34.583q.583 0 .979-.395.396-.396.396-.98 0-.583-.396-.979T20 31.833q-.583 0-.979.396t-.396.979q0 .584.396.98.396.395.979.395ZM11.333 28.5h17.334V8.792H11.333Zm0-22.333h17.334V4.708H11.333Zm0 24.958v4.167Zm0-24.958V4.708v1.459Z"
                    fill="#989898"></path>
                </svg>
              </div>
            </div>
            <div class="d-flex align-items-center flex-column flex-md-row w-100">
              <p class="mb-0" id="viewphonerecoverystep"><b>Step 2:</b><br>Recovery Phone Number </p>
              <div class="d-flex align-items-center w-100 justify-content-between" id="viewphonerecovery">
                <div><label class="fw-bold d-block small-sm">Phone Number</label><label id="UpdatedRecoveryPhoneNumber"></label></div>
                <a onclick="EditRecoveryPhoneNumber()">
                                                    <div class="d-flex justify-content-center align-items-center border boreder-danger  rounded-circle p-1">

                                                        <svg xmlns="http://www.w3.org/2000/svg" height="24" width="24"><path d="m10 21 4-4h8v4Zm-6-2h1.4l8.625-8.625-1.4-1.4L4 17.6ZM18.3 8.925l-4.25-4.2 1.4-1.4q.575-.575 1.413-.575.837 0 1.412.575l1.4 1.4q.575.575.6 1.388.025.812-.55 1.387ZM16.85 10.4 6.25 21H2v-4.25l10.6-10.6Zm-3.525-.725-.7-.7 1.4 1.4Z" fill="#989898"></path></svg>

                                                    </div>
                                                </a>
              </div>
            </div>
          </div>
        </div>
      </div>
    </div>
    <div class="text-end mt-5" id="skipforNow">
      <a href="javascript:void(0)" class="text-dark fw-bold text-decoration-none" onclick="CheckIsConsentSigned()">
                                Skip For Now
                                <svg xmlns="http://www.w3.org/2000/svg" height="24" width="24"><path d="M16.5 18V6h2v12Zm-11 0V6l9 6Zm2-6Zm0 2.25L10.9 12 7.5 9.75Z"></path></svg>
                            </a>
    </div>
  </div>
  <div class="text-end my-3">
    <button data-bb-handler="delete" type="button" class="btn bg-secondary text-white fw-bold px-4 rounded" onclick="CheckIsConsentSigned()" style="display:none" id="CheckIsFirstSigninAttempt">Continue <span class="spinner-border spinner-border-sm"
        role="status" aria-hidden="true" id="CheckIsFirstSigninAttemptSpinner" style="display:none;"></span></button>
  </div>
  <!-- Modal -->
  <!-- Modal -->
  <div class="modal fade" id="staticBackdrop" data-bs-backdrop="static" data-bs-keyboard="false" tabindex="-1" aria-labelledby="staticBackdropLabel" aria-hidden="true">
    <div class="modal-dialog  modal-dialog-centered">
      <div class="modal-content">
        <div class="modal-header">
          <h5 class="modal-title fw-bold fs-6" id="staticBackdropLabel">Set Recovery Email Address</h5>
          <button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button>
        </div>
        <div class="modal-body">
          <div id="recoveryEmailField">
            <div id="recoveryEmailText" class="mb-3">
              <div class="small"> Enter the recovery email address below and click Verify. A One-Time Access Code will be sent to this email address for verification. We recommend using your personal email address. </div>
            </div>
            <div id="addrecoveryEmailAddress">
              <span id="temprecoveryEmailAddress"></span>
              <div id="recoveryEmailAddresssubdiv">
                <div class="input-group align-items-center">
                  <span class="input-group-text position-absolute bg-transparent border-0 z-index-popover" id="addon-wrapping">
                    <svg xmlns="http://www.w3.org/2000/svg" height="24px" viewBox="0 0 24 24" width="24px" fill="#000000">
                      <path d="M0 0h24v24H0V0z" fill="none"></path>
                      <path d="M22 6c0-1.1-.9-2-2-2H4c-1.1 0-2 .9-2 2v12c0 1.1.9 2 2 2h16c1.1 0 2-.9 2-2V6zm-2 0l-8 4.99L4 6h16zm0 12H4V8l8 5 8-5v10z" fill="#989898" class="fill"></path>
                    </svg>
                  </span>
                  <input class="form-control ps-5" id="recoveryemailAddress" maxlength="50" name="RecoveryEmailAddress" placeholder="Email Address" tabindex="1" type="text" value="">
                </div>
              </div>
            </div>
          </div>
          <div id="EdidPoupRecoveryEmailAddress">
            <div>
              <div class="d-flex align-items-center mb-2">
                <p id="UpdatedRecoveryEmailAddressPopup" class="fw-500 h6  mb-0 me-2 small"></p>
                <a onclick="EdidPoupRecoveryEmailAddress()">
                                                    <div class="d-flex justify-content-center align-items-center border boreder-danger  rounded-circle p-1">

                                                        <svg xmlns="http://www.w3.org/2000/svg" height="24" width="24"><path d="m10 21 4-4h8v4Zm-6-2h1.4l8.625-8.625-1.4-1.4L4 17.6ZM18.3 8.925l-4.25-4.2 1.4-1.4q.575-.575 1.413-.575.837 0 1.412.575l1.4 1.4q.575.575.6 1.388.025.812-.55 1.387ZM16.85 10.4 6.25 21H2v-4.25l10.6-10.6Zm-3.525-.725-.7-.7 1.4 1.4Z" fill="#989898"></path></svg>

                                                    </div>
                                                </a>
              </div>
            </div>
            <div>
              <div id="recoveryOTPField">
                <div id="recoveryEmailOTPtext">
                  <div class="  mb-1 fw-bold small-sm">One Time Access Code</div>
                  <div class="small mb-2">Enter the One Time Access Code below to verify your recovery email.</div>
                </div>
                <div class="input-group">
                  <span class="input-group-text pt-2 position-absolute bg-transparent border-0 z-index-popover" id="addonwrappingEmailRecoverywrapping">
                    <svg xmlns="http://www.w3.org/2000/svg" height="24px" viewBox="0 0 24 24" width="24px" fill="#000000">
                      <path d="M0 0h24v24H0V0z" fill="none"></path>
                      <path
                        d="M12 6c3.79 0 7.17 2.13 8.82 5.5C19.17 14.87 15.79 17 12 17s-7.17-2.13-8.82-5.5C4.83 8.13 8.21 6 12 6m0-2C7 4 2.73 7.11 1 11.5 2.73 15.89 7 19 12 19s9.27-3.11 11-7.5C21.27 7.11 17 4 12 4zm0 5c1.38 0 2.5 1.12 2.5 2.5S13.38 14 12 14s-2.5-1.12-2.5-2.5S10.62 9 12 9m0-2c-2.48 0-4.5 2.02-4.5 4.5S9.52 16 12 16s4.5-2.02 4.5-4.5S14.48 7 12 7z"
                        fill="#989898" class="fill" id="recoveryEmaileyeIcon"></path>
                    </svg>
                  </span>
                  <input class="form-control ps-5" id="recoveryEmailOTP" maxlength="6" name="RecoveryEmailOTP" placeholder="Enter last 6 digits of OTA" type="text" value="">
                </div>
                <div class="text-left mt-2 small text-muted"> Didn't receive a code? <a class=" fw-500 text-danger" onclick="fnSendOTPForRecoveryEmailAddress('Resend')" id="resendRecoveryEmailAddressOTAbtn">Resend  </a>
                  <span id="btnEmailRecoveryResndText"> (in <span id="txtEmailRecoveryResend">47</span>) </span>
                </div>
              </div>
            </div>
          </div>
          <div>
          </div>
        </div>
        <div class="modal-footer align-content-center justify-content-between">
          <button type="button" class="btn btn-secondary" data-bs-dismiss="modal">Close</button>
          <div>
            <button type="button" class="btn bg-secondary text-white fw-bold px-2 rounded" onclick="SendOTAByRecoveryEmail('send')" id="verifyRecoveryEmailbtn">Verify <span class="spinner-border spinner-border-sm" role="status" aria-hidden="true"
                id="verifyRecoveryEmailbtnspinner" style="display:none;"></span> </button>
          </div>
          <button type="button" class="btn bg-secondary text-white fw-bold px-2 rounded" onclick="FnCheckRecoveryEmailOTPExpiredAndValid()" id="recoveryEmailContinueBtn" style="display:none;" disabled="disabled">Continue <span
              class="spinner-border spinner-border-sm" role="status" aria-hidden="true" id="recoveryEmailContinuespinner" style="display:none;"></span></button>
        </div>
      </div>
    </div>
  </div>
  <!-- Modal -->
  <div class="modal fade" id="staticPhoneBackdrop" data-bs-backdrop="static" data-bs-keyboard="false" tabindex="-1" aria-labelledby="staticBackdropLabel" aria-hidden="true">
    <div class="modal-dialog  modal-dialog-centered">
      <div class="modal-content">
        <div class="modal-header">
          <h5 class="modal-title fw-bold fs-6" id="staticBackdropLabel">Set Recovery Phone Number</h5>
          <button type="button" class="btn-close" data-bs-dismiss="modal" aria-label="Close"></button>
        </div>
        <div class="modal-body">
          <div id="hiderecoveryPhonediv">
            <div id="recoveryPhoneText">
              <div class="small mb-3"> Enter the recovery phone number below and click Verify. A One-Time Access Code will be sent to this phone number for verification. We recommend using your current phone number. </div>
            </div>
            <div id="addrecoveryPhoneNumber">
              <div class="input-group align-items-center">
                <span class="input-group-text pt-2 position-absolute bg-transparent border-0 z-index-popover" id="addon-wrapping">
                  <svg xmlns="http://www.w3.org/2000/svg" height="24" width="24">
                    <path
                      d="M19.75 20.75q-3.1 0-6.087-1.413-2.988-1.412-5.3-3.724Q6.05 13.3 4.638 10.325 3.225 7.35 3.225 4.25q0-.45.288-.738.287-.287.737-.287h3.875q.35 0 .613.212Q9 3.65 9.05 4l.65 3.4q.05.3-.012.575-.063.275-.288.5l-2.35 2.4q1.05 1.8 2.6 3.337 1.55 1.538 3.475 2.738L15.5 14.6q.225-.225.513-.313.287-.087.587-.037l3.375.675q.35.075.575.337.225.263.225.613v3.85q0 .45-.287.737-.288.288-.738.288ZM6.15 9.1 7.8 7.45 7.35 5.1h-2.2q.1 1 .338 2.012.237 1.013.662 1.988Zm8.75 8.725q.95.425 1.963.675 1.012.25 2.037.325v-2.2l-2.3-.5ZM6.15 9.1Zm8.75 8.725Z"
                      fill="#989898"></path>
                  </svg>
                </span>
                <input class="form-control ps-5" id="recoveryPhoneNumber" maxlength="14" name="RecoveryPhoneNumber" placeholder="Phone Number" tabindex="1" type="text" value="">
              </div>
            </div>
          </div>
          <div id="otpfiedforrecoveryphonenumber" style="display:none">
            <div id="EditRecoveryPhoneNumberPopup">
              <div class="d-flex align-items-center mb-2">
                <p id="UpdatedRecoveryPhoneNumberPopup" class="fw-500 h6  mb-0 small"></p>
                <a onclick="EditRecoveryPhoneNumberPopup()">
                                                        <div class="d-flex justify-content-center align-items-center border boreder-danger  rounded-circle p-1 ms-2">

                                                            <svg xmlns="http://www.w3.org/2000/svg" height="24" width="24"><path d="m10 21 4-4h8v4Zm-6-2h1.4l8.625-8.625-1.4-1.4L4 17.6ZM18.3 8.925l-4.25-4.2 1.4-1.4q.575-.575 1.413-.575.837 0 1.412.575l1.4 1.4q.575.575.6 1.388.025.812-.55 1.387ZM16.85 10.4 6.25 21H2v-4.25l10.6-10.6Zm-3.525-.725-.7-.7 1.4 1.4Z" fill="#989898"></path></svg>

                                                        </div>
                                                    </a>
              </div>
            </div>
            <div class="">
              <div>
                <div id="recoveryPhoneOTPField">
                  <div id="recoveryphoneOTPtext">
                    <div class="fw-bold  mb-1 small-sm">One Time Access Code</div>
                    <div class="mb-2 small">Enter the one Time Access Code below to verify your recovery phone number.</div>
                  </div>
                  <div class="input-group">
                    <span class="input-group-text pt-2 position-absolute bg-transparent border-0 z-index-popover" id="addon-wrapping">
                      <svg xmlns="http://www.w3.org/2000/svg" height="24px" viewBox="0 0 24 24" width="24px" fill="#000000">
                        <path d="M0 0h24v24H0V0z" fill="none"></path>
                        <path
                          d="M12 6c3.79 0 7.17 2.13 8.82 5.5C19.17 14.87 15.79 17 12 17s-7.17-2.13-8.82-5.5C4.83 8.13 8.21 6 12 6m0-2C7 4 2.73 7.11 1 11.5 2.73 15.89 7 19 12 19s9.27-3.11 11-7.5C21.27 7.11 17 4 12 4zm0 5c1.38 0 2.5 1.12 2.5 2.5S13.38 14 12 14s-2.5-1.12-2.5-2.5S10.62 9 12 9m0-2c-2.48 0-4.5 2.02-4.5 4.5S9.52 16 12 16s4.5-2.02 4.5-4.5S14.48 7 12 7z"
                          fill="#989898" class="fill" id="eyeIconForPhoneRecovery"></path>
                      </svg>
                    </span>
                    <input class="form-control ps-5" id="recoveryPhoneOTP" maxlength="6" name="RecoveryPhoneNumberOTP" placeholder="Enter last 6 digits of OTP" type="text" value="">
                  </div>
                </div>
                <div class=" mb-3 mt-2 small text-muted"> Didn't receive a code? <a class="text-center fw-500 text-danger" onclick="fnSendOTPForMoblie('Resend', false);" id="resendOTAPhoneNumber">Resend  </a>
                  <span id="btnPhoneResndText"> (in <span id="txtPhoneResend"> 47</span>) </span>
                </div>
              </div>
            </div>
          </div>
        </div>
        <div class="modal-footer justify-content-between">
          <button type="button" class="btn btn-secondary" data-bs-dismiss="modal">Close</button>
          <div>
            <button type="button" class="btn bg-secondary text-white fw-bold px-2 rounded" onclick="VerifyPhoneNumber('send');" id="verifyrecoveryPhoneNumberBtn">Verify <span class="spinner-border spinner-border-sm" role="status" aria-hidden="true"
                id="verifyrecoveryPhoneNumberspinner" style="display:none;"></span></button>
            <button type="button" class="btn bg-secondary text-white fw-bold rounded" id="recoveryPhoneContinueBtn" onclick="FnCheckOTPExpiredAndValid()" style="display:none;" disabled="disabled">Continue <span
                class="spinner-border spinner-border-sm" role="status" aria-hidden="true" id="recoveryPhoneContinueBtnspinner" style="display:none;"></span></button>
          </div>
        </div>
      </div>
    </div>
  </div>
</form>

Text Content

 * 
   This secure portal enables you to view and download your ACA Forms
   1095-B/1095-C/MA1099-HC at any time
 * 
   You will receive email notifications if your employer files any corrections
   to your ACA Forms


ACCESS YOUR ACA FORMS ONLINE

You will receive a One Time Access (OTA) code to the below email address.

Email Address Enter your email address where you received the online access link

Last 4 digits of SSN Enter the last 4 digits of your SSN

Continue
 * 
   This secure portal enables you to view and download your ACA Forms
   1095-B/1095-C/MA1099-HC at any time
 * 
   You will receive email notifications if your employer files any corrections
   to your ACA Forms


ACCESS YOUR ACA FORMS ONLINE

We have sent the One Time Access Code(OTA) to your email address

One Time Access (OTA) Code: To verify, enter the One Time Access Code below

Didn't receive a code? Resend (in 47) seconds.
Submit

Set up Recovery Email Address and Phone Number

Adding a recovery phone number and email address will allow you to easily
recover your account if you forget your credentials

You can select, skip for now if you would prefer to add this information later.

Step 1:
Set Recovery Email Address

Add Email Address

Step 1:
Recovery Email Address

Email Address


Step 2:
Set Recovery Phone Number

Add Phone Number

Step 2:
Recovery Phone Number

Phone Number

Skip For Now
Continue

SET RECOVERY EMAIL ADDRESS

Enter the recovery email address below and click Verify. A One-Time Access Code
will be sent to this email address for verification. We recommend using your
personal email address.

One Time Access Code
Enter the One Time Access Code below to verify your recovery email.

Didn't receive a code? Resend (in 47)

Close
Verify
Continue

SET RECOVERY PHONE NUMBER

Enter the recovery phone number below and click Verify. A One-Time Access Code
will be sent to this phone number for verification. We recommend using your
current phone number.

One Time Access Code
Enter the one Time Access Code below to verify your recovery phone number.

Didn't receive a code? Resend (in 47)
Close
Verify Continue