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apply.coveredca.com Open in urlscan Pro
2a02:26f0:6c00:2a3::2a46  Public Scan

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Submitted URL: https://click.marketing.coveredca.com/?qs=9dc0f4a603594736d62e767000ebda58a312934bcb774e47b54f6de460118b8608e34c0a950d5bb995c03e8b81da...
Effective URL: https://apply.coveredca.com/static/lw-web/login?resource_url=https%3A%2F%2Fapply.coveredca.com%2Fapspahbx%2Fahbx.portal&utm_...
Submission: On December 06 via api from US — Scanned from DE

Form analysis 1 forms found in the DOM

<form>
  <div class="login">
    <div class="form-group required"><label id="username-label" for="username"><span
          id="login-login-username-label"><span>Username</span><a id="login-forgot-username-link" role="link" href="/static/lw-web/login/forgot-username"><span>Forgot username?</span></a></span><!-- react-text: 94 --><!-- /react-text --><!-- react-text: 95 --><!-- /react-text --><!-- react-text: 96 --><!-- /react-text --></label><!-- react-text: 97 --><!-- /react-text --><input
        type="text" name="username" maxlength="50" id="username" required="" aria-label="Username" autocomplete="username" value="" for="username" class="form-control"
        aria-describedby="username-error-required"><!-- react-text: 99 --><!-- /react-text --><!-- react-text: 100 --><!-- /react-text --></div>
    <div class="form-group required password-input"><label id="password-label" for="password"><span
          id="login-login-password-label"><span>Password</span><a id="login-forgot-password-link" role="link" href="/static/lw-web/login/forgot-password"><span>Forgot password?</span></a></span><!-- react-text: 107 --><!-- /react-text --><!-- react-text: 108 --><!-- /react-text --><!-- react-text: 109 --><!-- /react-text --></label><!-- react-text: 110 --><!-- /react-text --><input
        type="password" name="password" maxlength="50" id="password" required="" aria-label="Password" autocomplete="current-password" value="" for="password" class="form-control"
        aria-describedby="password-error-required"><a href="#" class="toggle" role="button"><span class="sr-only">Show</span></a><!-- react-text: 114 --><!-- /react-text --><!-- react-text: 115 --><!-- /react-text --></div><span></span><br>
    <div class="login-button-row row">
      <div class="col-xs-12 col-sm-8 col-sm-push-2 col-md-8 col-md-push-2"><button id="login-login-text" class="btn btn-primary btn-block" type="submit" disabled=""><span>Log In</span></button></div>
    </div>
  </div>
</form>

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