EthicsPoint

<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd"> <html lang="en" xmlns="http://www.w3.org/1999/xhtml" dir="ltr"> <head> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1; codepage=28591"/> <title>EthicsPoint</title> <link rel="shortcut icon" href="./../en/images/transparent.ico" > <script language="javascript" src="../common/java/common.js"></script> <script language="javascript" src="common/java/java_functions_1.js"></script> <script language="javascript" src="common/java/java_functions_2.js"></script> <link href="./common/reporterpages.css" rel="stylesheet" type="text/css"> <link rel="stylesheet" href="https://secure.ethicspoint.com/domain/media/shared/ciCLIENTIntake.css"> <meta name="keywords" content="cheating accountants, stealing from work, boss sexual harassment, fraudulent claims, corporate scam, corporate scheming, corporate scamming, corporate fraud"><meta name="description" content="EthicsPoint provides online reporting systems for companies looking to reduce fraud and abuse."> <meta NAME="Revisit" CONTENT="3 Days"> <meta name="robots" content="noindex, nofollow"> </head> <body> <div id="wrap"> <div id="banner"> <a href="default.asp"><img class="banner_logo" src="./../en/images/default_reporter/reporter_logo.gif" alt="" border="0" /></a> <p><span class="securetext">You are now in an EthicsPoint Secure Area </span><span class="filetext">| File a Report</span></p> </div> <div id="EP_Page">  <div><img src="./../en/images/default_reporter/white_box_top_780.gif" width="780" height="10" alt="" /></div> <div id="EP_ContentArea" >  <div class="EP_mainContent_border" style="background-color: #D5E5F6;"><img src="./../en/images/default_reporter/blue_box_top_780.gif" width="780" height="10" alt="" /></div> <div id="EP_mainContent" style="background-color: #D5E5F6;">   <table border="0" cellpadding="0" cellspacing="0" align="center"> <link rel="stylesheet" href="../Content/css/jquery-ui-1.13.2.min.css" /> <script src="../Scripts/jquery-3.7.1.min.js"></script> <script src="../Scripts/jquery-ui-1.13.2.min.js"></script> <script type="text/javascript" language="javascript"> function enableLanguageAutocomplete() { var otherLanguageRadio = $("#otherlanguageid"); var languageSelect = $("#dropdowntext"); var showAll = $("#showall"); var uiWidget= $(".ui-widget"); if(otherLanguageRadio.is(":checked")) { languageSelect.removeAttr("disabled"); //Enable auto complete uiWidget.removeAttr("disabled"); showAll.css("cursor","pointer"); showAll.attr("title", "Show all languages"); } else { languageSelect.val(""); // clear auto complete $("#languageid option[value='-1']").attr("selected","selected"); // Reset language select languageSelect.attr("disabled","disabled"); // disable auto complete uiWidget.attr("disabled","disabled"); showAll.css("cursor","default"); showAll.removeAttr("title"); } } // Self-Executing Anonymous Function pattern (function( $ ) { $.widget( "custom.combobox", { _create: function() { this.wrapper = $( "<span>" ) .addClass( "custom-combobox" ) .insertAfter( this.element ); this.element.hide(); this.createAutocomplete(); this.createShowAllButton(); enableLanguageAutocomplete(); }, createAutocomplete: function() { var selected = this.element.children( ":selected" ); var value = selected.val() ? selected.text() : ""; if( $("#invalidlanguage").val() !== "" ) { value = $("#invalidlanguage").val(); } this.input = $( "<input>" ) .appendTo( this.wrapper ) .val( value ) .attr({ id: "dropdowntext", title: "", disabled: "disabled" }) .removeClass( "ui-corner-all" ) .addClass( "custom-combobox-input ui-widget ui-widget-content ui-state-default" ) .autocomplete({ delay: 0, minLength: 0, source: $.proxy( this, "source" ), select: function(event, ui) { $("#languageid option[value='"+ui.item.id+"']").attr("selected","selected"); } }); }, createShowAllButton: function() { var input = this.input; var wasOpen = false; $( "<a>" ) .attr( "tabIndex", -1 ) .attr({ id: "showall", title: "Show all languages" }) .appendTo( this.wrapper ) .button({ icons: { primary: "ui-icon-triangle-1-s" }, text: false }) .removeClass( "ui-corner-all" ) .addClass( "custom-combobox-toggle" ) .mousedown(function() { wasOpen = input.autocomplete( "widget" ).is( ":visible" ); }) .click(function() { input.focus(); // Close if already visible if ( wasOpen || $("#otherlanguageid").is(":checked") === false ) { return; } // Pass empty string as value to search for, displaying all results input.autocomplete( "search", "" ); }); }, source: function( request, response ) { var matcher = new RegExp( "^" +$.ui.autocomplete.escapeRegex(request.term), "i" ); response( this.element.children( "option" ).map(function() { var text = $( this ).text(); var id = $( this ).val(); if ( this.value && ( !request.term || matcher.test(text) ) ) { return { label: text, value: text, id: id, option: this }; } }) ); } }); })( jQuery ); function checkValidLanguage() { if($("#englishlanguageid").is(":checked")) { return; } var value = $("#dropdowntext").val(); var valueLowerCase = $.trim(value.toLowerCase()); var isValid = false; $("#languageid").children( "option" ).each(function() { if ( $( this ).text().toLowerCase() === valueLowerCase ) { isValid = true; this.selected = true; $("#invalidlanguage").val(""); return false; } }); if(!isValid) { $("#invalidlanguage").val(value); $("#languageid option[value='-1']").attr("selected","selected"); } } $(function() { $("#languageid").combobox(); $(".txtDatepicker").datepicker({ changeMonth: true, changeYear: true, showButtonPanel: true, yearRange: '2002:2032' }); $(".txtDatepicker").keypress(function (event) { if (event.keyCode == 13) { event.preventDefault(); } }); }); var releaseToggle = 'True'; if (releaseToggle === 'True') { $(document).ready(function () { if ($('#misfileCaseid').is(":checked")) { $('#misfileCaseReason').prop("disabled", false); } else { $('#misfileCaseReason').val(''); } }); function showMisfile() { var $textMisfileReason = $('#misfileCaseReason').val(); if ($('#misfileCaseid').is(":checked")) { $('#misfileCaseReason').val($('#hfmisfileCaseReason').val()); $('#misfileCaseReason').prop("disabled", false); } else { $('#hfmisfileCaseReason').val($textMisfileReason); $('#misfileCaseReason').val(''); $('#misfileCaseReason').prop("disabled", true); } } } </script> <script language="javascript" src="common/java/DynamicOptionList.js"></script> <noscript></noscript> <script language="javascript"> function SubmitClick() { document.getElementById("submit_button").style.visibility = "hidden"; document.getElementById("wait_image").style.display = "block"; var idAnonymousChk = document.getElementById("Anonymous_Yes"); if (idAnonymousChk != null) { if (idAnonymousChk.checked) { var idIdentitylayer = document.getElementById("identitylayer"); if (idIdentitylayer != null) { idIdentitylayer.innerHTML = ''; } } } else { document.getElementById("AnonymousReporterEmail").value = ""; } } </script> <noscript></noscript> <script language="javascript"> function AnonymousClick(strManual) { if (strManual == true) { document.getElementById("ReporterName_First").value = ""; document.getElementById("ReporterName_Last").value = ""; document.getElementById("ReporterPhone").value = ""; document.getElementById("ReporterEmail").value = ""; document.getElementById("ReporterAvailability").value = ""; document.getElementById("identitylayer").style.display = "none"; } else { document.getElementById("identitylayer").style.display = "block"; } } </script> <noscript></noscript> <tr> <td width="665" align="left" valign="top">  <table border="0" cellpadding="0" cellspacing="0"> <tr> <td width="665" style="padding:10px" align="left" valign="top"> <form action="report_information.asp" method="post" id="caseform" name="caseform"> <div class="norm12"> <font class="white13">ETHICSPOINT IS <u>NOT</u> A 911 OR EMERGENCY SERVICE.</font><br/> <font color="#AA0000">Do not use this site to report events presenting an immediate threat to life or property. Reports submitted through this service may not receive an immediate response. If you require emergency assistance, please contact your local authorities.</font> <p> <table border="0" cellpadding="0" cellspacing="0" id="terms-block"> <tr bgcolor=""> <td valign="top"><input type="checkbox" name="agreement" id="agreement" value="yes" />  </td> <td valign="top" class="norm12"> <font class="required">*</font> <label for="agreement">Yes - I agree to the <a href="javascript:void(0)" onclick="window.open('report_agreement.asp?termsid=1&key=5n0uCDdEKcIcY8QsfM','Report_Agreement','toolbar=no,location=no,directories=no,scrollbars=yes,status=yes,resize=yes,resizable=yes,menubar=no,width=510,height=400');"><b><u>Terms and Conditions</u></b></a> of making this report.</label></td> </tr> </table> <p> <font class="bluetext">Please provide information as follows:</font> <br/>( <font class="required">*</font> Required fields ) </div> <P> <table border="0" cellpadding="2" cellspacing="1" align="center" width="600"> <tr id="organization"> <td id="organization-label" bgcolor="" class="normform" align="right">Organization/Tier:</td> <td id="organization-name" class="normform" bgcolor=""><b>Mass General Brigham Health Plan</b> </td> </tr> <tr> <td bgcolor="" class="normform" align="right" valign="top"><label for="CompanyLocation">Location:</label></td> <td bgcolor="" > <textarea id="CompanyLocation" name="CompanyLocation" rows="3" cols="43" class="norm12" ></textarea><br/> <font class="norm12" id="location-example"> Physical address, branch and/or store number </font> </td> </tr> <tr> <td bgcolor="" class="normform" align="right"><label for="CompanyCity">City:</label></td> <td bgcolor="" > <input id="CompanyCity" name="CompanyCity" value="" type="text" size="20" maxlength="50" class="norm12"/>   <label for="CompanyState"><font class="normform">State/Province:</font></label>  <input name="CompanyState" id="CompanyState" value="" type="text" size="3" maxlength="50" class="norm12"/> </td> </tr> <tr> <td bgcolor="" class="normform" align="right"><label for="CompanyZip">Zip/Postal Code:</label></td> <td bgcolor="" > <input id="CompanyZip" name="CompanyZip" value="" type="text" size="10" maxlength="15" class="norm12"/> </td> </tr> <tr> <td bgcolor="" class="normform" align="right"><label for="CompanyCountry">Country:</label></td> <td bgcolor="" > <input id="CompanyCountry" name="CompanyCountry" value="" type="text" size="40" maxlength="50" class="norm12"/> </td> </tr> <tr> <td colspan="2"><hr></td> </tr> </table> <table border="0" cellpadding="3" cellspacing="0" align="center" width="600"> <tr bgcolor=""> <td rowspan="2" width="50" bgcolor="" align="center" valign="top"><img src="images/gt.gif" alt=""/></td> <td class="bluetext"> <font class="required">*</font> <label for="custom_1767525"> <span class="htmlcontainer">What is your relationship to Mass General Brigham Health Plan?</span> </label> </td> </tr> <tr bgcolor=""> <td colspan="2"> <table border="0" cellspacing="0" cellpadding="0"> <tr> <td>          </td> <td class="norm12" valign="top"> <select id="custom_1767525" name="custom_1767525"> <option value="" selected>- Select One -</option> <option value="Member" > Member </option> <option value="Provider" > Provider </option> <option value="Employee" > Employee </option> <option value="Other" > Other </option> </select> </td> </tr> </table> </td> </tr> <tr> <td bgcolor="" class="bluetext" align="left" colspan="2">          <font class="required">*</font> <b id="anonymous-label">Do you wish to remain ANONYMOUS for this report?</b> </td> </tr> <tr> <td bgcolor="" class="norm12" colspan="2">                  <input type="radio" id="Anonymous_Yes" name="Anonymous" onclick="AnonymousClick(true);" value="1" />  <label for="Anonymous_Yes">Yes</label>    <input type="radio" id="Anonymous_No" onclick="AnonymousClick(false);" name="Anonymous" value="-1" />  <label for="Anonymous_No">No</label> </td> </tr> <tr> <td bgcolor="">         </td> <td bgcolor=""> <div name="identitylayer" id="identitylayer" style="display : block;"> <font class="bluetext" id="reporter-section-label">If you want Mass General Brigham Health Plan to know your identity, please complete the following:</font><br/> <table border="0" cellpadding="2" cellspacing="0" bgcolor=""> <tr bgcolor=""> <td class="normform" align="right"> Your Name:</td> <td> <table border="0" cellpadding="0" cellspacing="0"> <tr> <td ><input id="ReporterName_First" name="ReporterName_First" value="" type="text" size="20" maxlength="50" class="norm12"/> </td> <td ><input id="ReporterName_Last" name="ReporterName_Last" value="" type="text" size="23" maxlength="50" class="norm12"/></td> </tr> <tr> <td class="footnote"><label for="ReporterName_First">First Name</label></td> <td class="footnote"><label for="ReporterName_Last">Last Name</label></td> </tr> </table> </td> </tr> <tr> <td class="normform" align="right"><label for="ReporterPhone">Your Phone Number:</label></td> <td ><input id="ReporterPhone" name="ReporterPhone" value="" type="text" size="40" maxlength="50" class="norm12"/></td> </tr> <tr> <td class="normform" align="right"><label for="ReporterEmail">Your Email Address:</label></td> <td ><input id="ReporterEmail" name="ReporterEmail" value="" type="text" size="40" maxlength="100" class="norm12"/></td> </tr> <tr> <td colspan="3" class="normform"> <label for="ReporterAvailability">Best time for communication with you:</label></td> </tr> <tr> <td></td> <td > <textarea id="ReporterAvailability" name="ReporterAvailability" rows="5" cols="53" class="norm12" ></textarea> </td> </tr> </table> </div> </td> </tr> <tr bgcolor=""> <td width="50" bgcolor="" align="center" valign="top"><img src="images/gt.gif" alt=""/></td> <td> <font class="bluetext" align="justify"> <font class="required">*</font> Please provide all details regarding your inquiry: <p> <table border="0"> <tr> <td valign="top" > <textarea id="details" name="Details" rows="15" cols="73" class="norm12" ></textarea></td> <td valign="top" class="norm12"> <font color="#000000"></font> </td> </tr> </table> </font> </td></tr> <tr> <td bgcolor=""> </td> <td bgcolor="#000066"> <font class="norm" align="justify"><font color="#FFFFFF"><b> When you submit the report, you will be issued a <b>Report Key</b>. Please write it down and keep it in a safe place. We ask you to use this <b>Report Key</b> along with the password of your choosing to return to EthicsPoint through the website or telephone hotline in 5-6 business days. By returning in 5-6 business days, you will have the opportunity to review any Follow-up Questions or submit more information about this incident. </b></font></font> </td></tr> <tr> <td width="50" bgcolor="" align="center" valign="top"><img src="images/gt.gif" alt=""/></td> <td> <table border="0" cellpadding="2" cellspacing="1"> <tr> <td colspan="2" class="bluetext" id='choose-password'>Please choose a password for this report:</td> </tr> <tr> <td bgcolor="#FFFAD2" class="normform" align="right" valign="top"> <font class="required">*</font> <label for="password1" id='password1-label'>Password:</label></td> <td bgcolor="#FFCC7B"> <input type="password" id="password1" name="password1" value="" size="45" maxlength="30" autocomplete="off"/> </td> </tr> <tr> <td bgcolor="#FFFAD2" class="normform" align="right" valign="top"> <font class="required">*</font> <label for="password2" id="password2-label">Re-enter<br>Password:</label></td> <td bgcolor="#FFCC7B"> <input type="password" id="password2" name="password2" value="" size="45" maxlength="30" autocomplete="off"/> </td> </tr> <tr> <td bgcolor="#FFFAD2" colspan="2" class="norm12"><b id='password-length'>Your passwords must match and be at least four characters long.</b></td> </tr> </table> </td> </tr> </table> <table align="center"> <tr> <td colspan="2"><br/><center> <div id="submit_capsule" style="width: 300px; height: 24px;"><img id="wait_image" src="images/translated/submit_waiting.gif" alt="Please Wait..." style="display:none;"/></div><div id="submit_button" style="width: 300px; height: 24px;"><input type="submit" name="submit" value="Submit Report" onClick="SubmitClick();"/></div> </center><br/></td> </tr> </table> <input type="hidden" name="command" value="submit"/> <input type="hidden" name="key" value="8p6BqUKt3DyeUDUN4t21720250053"/> <input type="hidden" name="dataprivacy" value="No"/> <input type="hidden" name="dataprivacylocation" value=""/> <input type="hidden" name="dataprivacyreason" value="0"/> <input type="hidden" name="otheroverride" value="yes"/> <input type="hidden" name="CompanyName" value="Mass General Brigham Health Plan"/> <input type="hidden" name="ClientID" value="47250"/> <input type="hidden" name="LocationID" value="-1"/> <input type="hidden" name="ViolationTypeID" value="158356"/> <input type="hidden" name="ViolationCategoryID" value="0"/> </form> <script> $(".htmlcontainer").each(function(index, element){ $(element).html($.parseHTML($(element).text(), document, true)); }); </script> </td> </tr> </table> </td> </tr> </table>  </div>  <div class="EP_mainContent_border" style="background-color: #D5E5F6;"><img src="./../en/images/default_reporter/blue_box_bottom_780.gif" width="780" height="10" alt="" /></div> </div>  <div><img src="./../en/images/default_reporter/white_box_top2_780.gif" width="780" height="10" alt="" /></div> </div>  <div id="footer" class="footer-gradient"> <div class="footer-container"> <div class="footer-container__img"> <a href="http://www.navexglobal.com/" target="_blank"> <img src="images/navex_rebrand_footer_white.svg" style="float:right; height:24px; padding-right:20px;" alt="NAVEX" border="0"/> </a> </div> <div class="footer-container__text"> <a href="http://www.navexglobal.com/privacy-statement" target="_blank">Privacy Statement</a>   |  <a href="http://www.navexglobal.com/terms-of-use" target="_blank">Terms of Use</a>   |  <a href="https://www.navex.com/cookie-statement/" target="_blank">Cookie Statement</a>      <div class="footer-container__copyright">© 2025 NAVEX Global Inc., All Rights Reserved.</div> </div> <div class="footer-container__img"> <div style="float: right"><div><a href="//privacy.truste.com/privacy-seal/validation?rid=90dc38ca-6e1d-4f98-bbd4-9931d1681c0a" target="_blank"><img style="border: none; height: 33px; width: 104px;" src="//privacy-policy.truste.com/privacy-seal/seal?rid=90dc38ca-6e1d-4f98-bbd4-9931d1681c0a" alt="TRUSTe" /></a></div></div> <a id="sas70" target="_blank"> <img style="float: right; padding-right: 10px;" alt="SAS70 Type II" src="images/sas70-logo.gif"/> </a> </div> </div> </div>  <script type="text/javascript" src="/_Incapsula_Resource?SWJIYLWA=719d34d31c8e3a6e6fffd425f7e032f3&ns=2&cb=613566064" async></script></body> </html>

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