agent-qa.bcbsm.com Open in urlscan Pro
167.242.25.55  Public Scan

Form analysis
1 forms found in the DOM

Name: frmLogin — POST https://digsauth-qa.bcbsm.com/celogin/agent/

<form name="frmLogin" method="post" autocomplete="off" action="https://digsauth-qa.bcbsm.com/celogin/agent/">
  <input type="hidden" name="auth_mode" value="basic">
  <input type="hidden" name="constituency" value="agent">
  <table border="0" cellpadding="3" cellspacing="1" width="70%" id="dataTable">
    <tbody>
      <tr valign="top">
        <td id="formLabelReq">User Name</td>
        <td class="underscore"><input type="text" name="username" class="input-block-level" tabindex="1" id="user" maxlength="20"></td>
      </tr>
      <tr valign="top">
        <td id="formLabelReq">Password</td>
        <td class="underscore"><input type="password" name="password" class="input-block-level" tabindex="2" id="pwd" maxlength="40" onchange="this.form.B1.focus()"></td>
      </tr>
      <tr valign="top">
        <td id="btnleft" nowrap="nowrap">&nbsp;</td>
        <td id="btnright" nowrap="nowrap">
          <br>
          <input type="hidden" name="login-form-type" value="pwd">
          <a href="javascript: frmLogin.submit()" class="button" id="loginbtn">Login</a>
          <a href="http://www.bcbsm.com/" class="button-grey">Cancel</a>
        </td>
      </tr>
    </tbody>
  </table>
</form>

Text Content

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