<% String submit = ""; if (request.getParameter("Submit") != null) { submit = request.getParameter("Submit"); } HashMap map = new HashMap(); Iterator iter = null; if(submit == null || submit.equals("")){ %>

Contact Us Got questions? Interested in learning more about UnitedHealthcare Shared Services? Fill out the form below and with a click, we're ready to help. But please, fill out the form completely so we can get you the right information quickly.
Name (required):
ID Number as shown on ID card (optional - Do not enter Social Security Number):
Employer:
Group Number:
Employee / Dependent:
Address 1:
Address 2:
City:
State
Zip:
Comments / Questions:
You must provide either a valid E-Mail Address or a Phone Number. If your inquiry pertains to protected health information, please provide a phone number where we can reach you. We will only respond to requests of this nature via the telephone.
Phone Number:
E-Mail:

<%}else{ String name = request.getParameter("name"); String idCard = request.getParameter("idCard"); String employer = request.getParameter("employer"); String group = request.getParameter("group"); String employee = request.getParameter("employee"); String address1 = request.getParameter("address1"); String address2 = request.getParameter("address2"); String city = request.getParameter("city"); String state = request.getParameter("state"); String zip = request.getParameter("zip"); String subjectNumber = request.getParameter("subject"); String comments = request.getParameter("comments"); String phone = request.getParameter("phone"); String email = request.getParameter("email"); boolean isValid = true; if((phone != null && !phone.equals("")) || (email != null && !email.equals(""))){ isValid = true; }else{ isValid = false; } if(name == null || name.equals("")){ isValid = false; } if(isValid){ try{ String emailAddress = ""; String subject = ""; //emailAddress = "nick.desteffen@wausaubenefits.com"; //emailAddress = "christopher.perry@wausaubenefits.com"; emailAddress = "uhis@umr.com"; subject = "UnitedHealth Integrated Services Information/Help"; //Build email String messageText = "Name: " + name + "\r"; messageText = messageText + "ID Card Number: " + idCard + "\r"; messageText = messageText + "Employer: " + employer + "\r"; messageText = messageText + "Group Number: " + group + "\r"; messageText = messageText + "Employee/Dependent: " + employee + "\r"; messageText = messageText + "\r"; messageText = messageText + "Address: " + address1 + "\r"; messageText = messageText + " " + address2 + "\r"; messageText = messageText + "City: " + city + "\r"; messageText = messageText + "State: " + state + "\r"; messageText = messageText + "Zip: " + zip + "\r"; messageText = messageText + "\r"; messageText = messageText + "Phone: " + phone + "\r"; messageText = messageText + "Email: " + email + "\r"; messageText = messageText + "\r"; messageText = messageText + "Comments:" + "\r"; messageText = messageText + comments; Properties props = new Properties(); props.put("mail.smtp.host", "mailo2.uhc.com"); Session mailSession = Session.getDefaultInstance(props, null); mailSession.setDebug(false); Message msg = new MimeMessage(mailSession); //if(!EmailValidator.getInstance().isValid(email)){ email = "UMR-WebApplication@umr.com"; //} else { // make new address For those who have entered an email // email = "UMR-WebApplication@umr.com"; //} InternetAddress addressFrom = new InternetAddress(email); msg.setFrom(addressFrom); InternetAddress[] addressTo = new InternetAddress[1]; addressTo[0] = new InternetAddress(emailAddress); msg.setRecipients(Message.RecipientType.TO, addressTo); msg.setSubject(subject); msg.setContent(messageText, "text/plain"); Transport.send(msg); }catch(Exception e){ System.out.println(e); }finally{ /*if(con != null){ con.close(); }*/ } session.removeAttribute("subjects");%>

<%}else{%>

Got questions? Interested in learning more about UnitedHealth Integrated Services? Fill out the form below and with a click, we're ready to help. But please, fill out the form completely so we can get you the right information quickly.
<%if(name == null || name.equals("")){ %> Name (required): <%}else{ %> Name: (required): <%}%>
ID Number as shown on ID card (optional - Do not enter Social Security Number):
Employer:
Group Number:
Employee / Dependent:
Address 1:
Address 2:
City:
State
Zip:
Comments / Questions:	<%=comments%>
You must provide either a valid E-Mail Address or a Phone Number. If your inquiry pertains to protected health information, please provide a phone number where we can reach you. We will only respond to requests of this nature via the telephone.
Phone Number:
E-Mail:

<%} }%>