function checkDate(){
var y = document.getElementById('effective_year_req').value
var m = document.getElementById('effective_month_req').value;
var d = '1';

var start = new Date();
// stoday
var startMo = start.getMonth();
var startD = start.getDate();
var startY = start.getFullYear();

var sel = new Date(y,m,d);
var selMo = sel.getMonth();
var selD = sel.getDate();
var selY = sel.getFullYear();

if (startD != 1) {
var mindate = new Date(startY,startMo + 2, 1);
var month = mindate.getMonth() + 1;
var day = mindate.getDate();
var year = mindate.getFullYear();
var good = (mindate.getTime());
var current = (sel.getTime());
if ((current - good) > 0){
 return true;
 } else {
 alert("Invalid entry! The next valid start date is " + month + "/" + day + "/" + year + " ");
		return false;
 }
}
if (startD == 1) {
var mindate = new Date((startMo + 1), 1, startY);
var month = mindate.getMonth() + 1;
var day = mindate.getDate();
var year = mindate.getFullYear();
var good = (mindate.getTime());
var current = (sel.getTime());
if ((current - good) > 0){
 return true;
 } else {
 alert("Invalid entry!  The next valid start date is " + month + "/" + day + "/" + year + " ");
			return false;
 }
}
}

function changeDiv(the_div,the_change)
{
  var the_style = getStyleObject(the_div);
  if (the_style != false)
  {
    the_style.display = the_change;
  }
}
function hideAll()
{
  changeDiv("agentBroker","none");
}
function getStyleObject(objectId) {
  if (document.getElementById && document.getElementById(objectId)) {
    return document.getElementById(objectId).style;
  } else if (document.all && document.all(objectId)) {
    return document.all(objectId).style;
  } else {
    return false;
  }
}
var status = 0;
function showDiv() {
	if (status == 0) {
		hideAll(); changeDiv('agentBroker','block');status = 1;}
	else {hideAll(); status = 0;}

}

function CheckNo(field, expected) 
{
	var valid = "0 1 2 3 4 5 6 7 8 9 . $ % ( ) - e x t"
	var ok = "yes";
	var temp;
	for (var i=0; i<field.value.length; i++) 
	{
	temp = "" + field.value.substring(i, i+1);
	if (valid.indexOf(temp) == "-1") ok = "no";
	}
	if (ok == "no") 
	{
		alert("Invalid entry!  Only " + expected + " are accepted!");
		field.value="";
		field.focus();
		field.select();	
		return false;
	}
}
function trim(inputString) 
{
	if (typeof inputString != "string") { return inputString; }
		   var retValue = inputString;
		   var ch = retValue.substring(0, 1);
		   while (ch == " ") {
		   retValue = retValue.substring(1, retValue.length);
		   ch = retValue.substring(0, 1);
   }
   	ch = retValue.substring(retValue.length-1, retValue.length);
	   while (ch == " ") {
      retValue = retValue.substring(0, retValue.length-1);
      ch = retValue.substring(retValue.length-1, retValue.length);
   }
   while (retValue.indexOf("  ") != -1) { 
      retValue = retValue.substring(0, retValue.indexOf("  ")) + retValue.substring(retValue.indexOf("  ")+1, retValue.length); // Again, there are two spaces in each of the strings
   }
   return retValue; 
}
function validlength(field,field1,name) {
	if(field.length == 0)
	{
	alert("Invalid entry! " +  name + " is empty!")
	field1.focus()
	return false;
	}
	else
	return true;
}
function checkemail(theEmail,field,name) {
	if(theEmail.match(/^([\w\-]+\.)*[\w\-]+\@([\w\-]+\.)+\w{2,3}$/)){
	return true;
	} else 	{
			alert("Invalid entry! " +  name + " format should be : xxx@xxx.xxx")
			//field.focus()	field.select()
			return false;
			}
	
}
function checkRadios(field,field1,name,name2) {
	myOption = -1;
	for (i=field-1; i > -1; i--) {
	if (field1[i].checked) {
	myOption = i;
	}
	}
	if (myOption == -1) {
	alert("Invalid entry! " +  name + " Please select " + name2)
	return false;
	}
	return true;
}
function checkCensus() {
	if((forMail.emp_only_30_M.value != "") || (forMail.emp_only_30_F.value != "") || (forMail.emp_spouse_30_M.value != "") || (forMail.emp_spouse_30_F.value != "") || (forMail.emp_child_30_M.value != "") || (forMail.emp_child_30_F.value != "") || (forMail.emp_family_30_M.value != "") || (forMail.emp_family_30_F.value != "")
	|| (forMail.emp_only_34_M.value != "") || (forMail.emp_only_34_F.value != "") || (forMail.emp_spouse_34_M.value != "") || (forMail.emp_spouse_34_F.value != "") || (forMail.emp_child_34_M.value != "") || (forMail.emp_child_34_F.value != "") || (forMail.emp_family_34_M.value != "") || (forMail.emp_family_34_F.value != "")
	|| (forMail.emp_only_39_M.value != "") || (forMail.emp_only_39_F.value != "") || (forMail.emp_spouse_39_M.value != "") || (forMail.emp_spouse_39_F.value != "") || (forMail.emp_child_39_M.value != "") || (forMail.emp_child_39_F.value != "") || (forMail.emp_family_39_M.value != "") || (forMail.emp_family_39_F.value != "")
	|| (forMail.emp_only_44_M.value != "") || (forMail.emp_only_44_F.value != "") || (forMail.emp_spouse_44_M.value != "") || (forMail.emp_spouse_44_F.value != "") || (forMail.emp_child_44_M.value != "") || (forMail.emp_child_44_F.value != "") || (forMail.emp_family_44_M.value != "") || (forMail.emp_family_44_F.value != "")
	|| (forMail.emp_only_49_M.value != "") || (forMail.emp_only_49_F.value != "") || (forMail.emp_spouse_49_M.value != "") || (forMail.emp_spouse_49_F.value != "") || (forMail.emp_child_49_M.value != "") || (forMail.emp_child_49_F.value != "") || (forMail.emp_family_49_M.value != "") || (forMail.emp_family_49_F.value != "")
	|| (forMail.emp_only_54_M.value != "") || (forMail.emp_only_54_F.value != "") || (forMail.emp_spouse_54_M.value != "") || (forMail.emp_spouse_54_F.value != "") || (forMail.emp_child_54_M.value != "") || (forMail.emp_child_54_F.value != "") || (forMail.emp_family_54_M.value != "") || (forMail.emp_family_54_F.value != "")
	|| (forMail.emp_only_59_M.value != "") || (forMail.emp_only_59_F.value != "") || (forMail.emp_spouse_59_M.value != "") || (forMail.emp_spouse_59_F.value != "") || (forMail.emp_child_59_M.value != "") || (forMail.emp_child_59_F.value != "") || (forMail.emp_family_59_M.value != "") || (forMail.emp_family_59_F.value != "")
	|| (forMail.emp_only_64_M.value != "") || (forMail.emp_only_64_F.value != "") || (forMail.emp_spouse_64_M.value != "") || (forMail.emp_spouse_64_F.value != "") || (forMail.emp_child_64_M.value != "") || (forMail.emp_child_64_F.value != "") || (forMail.emp_family_64_M.value != "") || (forMail.emp_family_64_F.value != "")
	|| (forMail.emp_only_65_M.value != "") || (forMail.emp_only_65_F.value != "") || (forMail.emp_spouse_65_M.value != "") || (forMail.emp_spouse_65_F.value != "") || (forMail.emp_child_65_M.value != "") || (forMail.emp_child_65_F.value != "") || (forMail.emp_family_65_M.value != "") || (forMail.emp_family_65_F.value != ""))
	{ return true;}
	else {alert("Requires at lease one entry in the Census Information!");return false;}
}
function validateArmadaCare() {
forMail.agent_name.value =trim(forMail.agent_name.value)
forMail.agent_phone.value =trim(forMail.agent_phone.value)
forMail.agent_fax.value =trim(forMail.agent_fax.value)
forMail.email_from_req.value =trim(forMail.email_from_req.value)
forMail.agency.value =trim(forMail.agency.value)
forMail.agent_notes.value =trim(forMail.agent_notes.value)
forMail.employer_req.value =trim(forMail.employer_req.value)
forMail.employer_address_req.value =trim(forMail.employer_address_req.value)
forMail.employer_city_req.value =trim(forMail.employer_city_req.value)
forMail.employer_state_req.value =trim(forMail.employer_state_req.value)
forMail.employer_zip_req.value =trim(forMail.employer_zip_req.value)
forMail.employer_phone_req.value =trim(forMail.employer_phone_req.value)
forMail.employer_fax.value =trim(forMail.employer_fax.value)
forMail.contact_name_req.value =trim(forMail.contact_name_req.value)
forMail.contact_phone_req.value =trim(forMail.contact_phone_req.value)
forMail.email_from.value =trim(forMail.email_from.value)
forMail.contact_fax.value =trim(forMail.contact_fax.value)
forMail.effective_month_req.value =trim(forMail.effective_month_req.value)
forMail.effective_date_req.value =trim(forMail.effective_date_req.value)
forMail.effective_year_req.value =trim(forMail.effective_year_req.value)
forMail.network_deductible_req.value =trim(forMail.network_deductible_req.value)
forMail.family_deductible_others.value =trim(forMail.family_deductible_others.value)
forMail.co_insurance_req.value =trim(forMail.co_insurance_req.value)
forMail.out_pocket_max_req.value =trim(forMail.out_pocket_max_req.value)
forMail.drug_co_pay_1_req.value =trim(forMail.drug_co_pay_1_req.value)
forMail.drug_co_pay_2.value =trim(forMail.drug_co_pay_2.value)
forMail.drug_co_pay_3.value =trim(forMail.drug_co_pay_3.value)
forMail.drug_co_pay_deductible.value =trim(forMail.drug_co_pay_deductible.value)
forMail.emp_only_30_M.value =trim(forMail.emp_only_30_M.value)
forMail.emp_only_30_F.value =trim(forMail.emp_only_30_F.value)
forMail.emp_spouse_30_M.value =trim(forMail.emp_spouse_30_M.value)
forMail.emp_spouse_30_F.value =trim(forMail.emp_spouse_30_F.value)
forMail.emp_child_30_M.value =trim(forMail.emp_child_30_M.value)
forMail.emp_child_30_F.value =trim(forMail.emp_child_30_F.value)
forMail.emp_family_30_M.value =trim(forMail.emp_family_30_M.value)
forMail.emp_family_30_F.value =trim(forMail.emp_family_30_F.value)
forMail.emp_only_34_M.value =trim(forMail.emp_only_34_M.value)
forMail.emp_only_34_F.value =trim(forMail.emp_only_34_F.value)
forMail.emp_spouse_34_M.value =trim(forMail.emp_spouse_34_M.value)
forMail.emp_spouse_34_F.value =trim(forMail.emp_spouse_34_F.value)
forMail.emp_child_34_M.value =trim(forMail.emp_child_34_M.value)
forMail.emp_child_34_F.value =trim(forMail.emp_child_34_F.value)
forMail.emp_family_34_M.value =trim(forMail.emp_family_34_M.value)
forMail.emp_family_34_F.value =trim(forMail.emp_family_34_F.value)
forMail.emp_only_39_M.value =trim(forMail.emp_only_39_M.value)
forMail.emp_only_39_F.value =trim(forMail.emp_only_39_F.value)
forMail.emp_spouse_39_M.value =trim(forMail.emp_spouse_39_M.value)
forMail.emp_spouse_39_F.value =trim(forMail.emp_spouse_39_F.value)
forMail.emp_child_39_M.value =trim(forMail.emp_child_39_M.value)
forMail.emp_child_39_F.value =trim(forMail.emp_child_39_F.value)
forMail.emp_family_39_M.value =trim(forMail.emp_family_39_M.value)
forMail.emp_family_39_F.value =trim(forMail.emp_family_39_F.value)
forMail.emp_only_44_M.value =trim(forMail.emp_only_44_M.value)
forMail.emp_only_44_F.value =trim(forMail.emp_only_44_F.value)
forMail.emp_spouse_44_M.value =trim(forMail.emp_spouse_44_M.value)
forMail.emp_spouse_44_F.value =trim(forMail.emp_spouse_44_F.value)
forMail.emp_child_44_M.value =trim(forMail.emp_child_44_M.value)
forMail.emp_child_44_F.value =trim(forMail.emp_child_44_F.value)
forMail.emp_family_44_M.value =trim(forMail.emp_family_44_M.value)
forMail.emp_family_44_F.value =trim(forMail.emp_family_44_F.value)
forMail.emp_only_49_M.value =trim(forMail.emp_only_49_M.value)
forMail.emp_only_49_F.value =trim(forMail.emp_only_49_F.value)
forMail.emp_spouse_49_M.value =trim(forMail.emp_spouse_49_M.value)
forMail.emp_spouse_49_F.value =trim(forMail.emp_spouse_49_F.value)
forMail.emp_child_49_M.value =trim(forMail.emp_child_49_M.value)
forMail.emp_child_49_F.value =trim(forMail.emp_child_49_F.value)
forMail.emp_family_49_M.value =trim(forMail.emp_family_49_M.value)
forMail.emp_family_49_F.value =trim(forMail.emp_family_49_F.value)
forMail.emp_only_54_M.value =trim(forMail.emp_only_54_M.value)
forMail.emp_only_54_F.value =trim(forMail.emp_only_54_F.value)
forMail.emp_spouse_54_M.value =trim(forMail.emp_spouse_54_M.value)
forMail.emp_spouse_54_F.value =trim(forMail.emp_spouse_54_F.value)
forMail.emp_child_54_M.value =trim(forMail.emp_child_54_M.value)
forMail.emp_child_54_F.value =trim(forMail.emp_child_54_F.value)
forMail.emp_family_54_M.value =trim(forMail.emp_family_54_M.value)
forMail.emp_family_54_F.value =trim(forMail.emp_family_54_F.value)
forMail.emp_only_59_M.value =trim(forMail.emp_only_59_M.value)
forMail.emp_only_59_F.value =trim(forMail.emp_only_59_F.value)
forMail.emp_spouse_59_M.value =trim(forMail.emp_spouse_59_M.value)
forMail.emp_spouse_59_F.value =trim(forMail.emp_spouse_59_F.value)
forMail.emp_child_59_M.value =trim(forMail.emp_child_59_M.value)
forMail.emp_child_59_F.value =trim(forMail.emp_child_59_F.value)
forMail.emp_family_59_M.value =trim(forMail.emp_family_59_M.value)
forMail.emp_family_59_F.value =trim(forMail.emp_family_59_F.value)
forMail.emp_only_64_M.value =trim(forMail.emp_only_64_M.value)
forMail.emp_only_64_F.value =trim(forMail.emp_only_64_F.value)
forMail.emp_spouse_64_M.value =trim(forMail.emp_spouse_64_M.value)
forMail.emp_spouse_64_F.value =trim(forMail.emp_spouse_64_F.value)
forMail.emp_child_64_M.value =trim(forMail.emp_child_64_M.value)
forMail.emp_child_64_F.value =trim(forMail.emp_child_64_F.value)
forMail.emp_family_64_M.value =trim(forMail.emp_family_64_M.value)
forMail.emp_family_64_F.value =trim(forMail.emp_family_64_F.value)
forMail.emp_only_65_M.value =trim(forMail.emp_only_65_M.value)
forMail.emp_only_65_F.value =trim(forMail.emp_only_65_F.value)
forMail.emp_spouse_65_M.value =trim(forMail.emp_spouse_65_M.value)
forMail.emp_spouse_65_F.value =trim(forMail.emp_spouse_65_F.value)
forMail.emp_child_65_M.value =trim(forMail.emp_child_65_M.value)
forMail.emp_child_65_F.value =trim(forMail.emp_child_65_F.value)
forMail.emp_family_65_M.value =trim(forMail.emp_family_65_M.value)
forMail.emp_family_65_F.value =trim(forMail.emp_family_65_F.value)

if(document.forMail.is_agent.checked) {
if(validlength(forMail.agent_name.value,forMail.agent_name,"Agent/Broker: Name")==true){
if(validlength(forMail.agent_phone.value,forMail.agent_phone,"Agent/Broker: Phone")==true){
if(validlength(forMail.email_from_req.value,forMail.email_from_req,"Agent/Broker: Email")==true){
if(checkemail(forMail.email_from_req.value,forMail.email_from_req.value,"Agent/Broker: Email")==true){
if(validlength(forMail.agency.value,forMail.agency,"Agent/Broker: Agency")==true){
if(validlength(forMail.employer_req.value,forMail.employer_req,"Employer Group: Name of Employer")==true){
if(validlength(forMail.employer_address_req.value ,forMail.employer_address_req ,"Employer Group: Address")==true){
if(validlength(forMail.employer_city_req.value ,forMail.employer_city_req ,"Employer Group: City")==true){
if(validlength(forMail.employer_state_req.value ,forMail.employer_state_req ,"Employer Group: State")==true){
if(validlength(forMail.employer_zip_req.value ,forMail.employer_zip_req ,"Employer Group: Zip")==true){
if(validlength(forMail.employer_phone_req.value ,forMail.employer_phone_req ,"Employer Group: Main Phone")==true){
if(validlength(forMail.contact_name_req.value ,forMail.contact_name_req ,"Employer Group: Contact Name")==true){
if(validlength(forMail.contact_phone_req.value ,forMail.contact_phone_req ,"Employer Group: Phone")==true){
if(validlength(forMail.email_from.value ,forMail.email_from ,"Employer Group: Email")==true){
if(checkemail(forMail.email_from.value,forMail.email_from,"Employer Group: Email")==true){
if(checkRadios(forMail.premium_req.length,forMail.premium_req,"ArmadaCare Plan:","Premium")==true){
if(checkRadios(forMail.maximums_req.length,forMail.maximums_req,"ArmadaCare Plan:","Maximums")==true){
if(checkRadios(forMail.plan_type_req.length,forMail.plan_type_req,"ArmadaCare Plan:","Plan Type")==true){
if(validlength(forMail.effective_month_req.value ,forMail.effective_month_req ,"ArmadaCare Plan: Effective Month")==true){
if(validlength(forMail.effective_year_req.value ,forMail.effective_year_req ,"ArmadaCare Plan: Effective Year")==true){
if(checkRadios(forMail.group_plan_req.length,forMail.group_plan_req,"Underlying Plan:","Group Plan")==true){
if(checkRadios(forMail.group_plan_hmo_req.length,forMail.group_plan_hmo_req,"Underlying Plan:","HMO")==true){
if(validlength(forMail.network_deductible_req.value ,forMail.network_deductible_req ,"Underlying Plan: Network Deductible")==true){
if(checkRadios(forMail.family_deductible_req.length,forMail.family_deductible_req,"Underlying Plan:","Family Deductible")==true){if(validlength(forMail.co_insurance_req.value ,forMail.co_insurance_req ,"Underlying Plan: Co-Insurance")==true){
if(validlength(forMail.out_pocket_max_req.value ,forMail.out_pocket_max_req ,"Underlying Plan: Out-of-Pocket Maximum")==true){
if(validlength(forMail.drug_co_pay_1_req.value ,forMail.drug_co_pay_1_req ,"Underlying Plan: Drug Co-Pay")==true){
if(checkCensus()==true){
return true;
}}}}}}}}}}}}}}}}}}}}}}}}}}}}
return false;
}
else {
if(validlength(forMail.employer_req.value,forMail.employer_req,"Employer Group: Name of Employer")==true){
if(validlength(forMail.employer_address_req.value ,forMail.employer_address_req ,"Employer Group: Address")==true){
if(validlength(forMail.employer_city_req.value ,forMail.employer_city_req ,"Employer Group: City")==true){
if(validlength(forMail.employer_state_req.value ,forMail.employer_state_req ,"Employer Group: State")==true){
if(validlength(forMail.employer_zip_req.value ,forMail.employer_zip_req ,"Employer Group: Zip")==true){
if(validlength(forMail.employer_phone_req.value ,forMail.employer_phone_req ,"Employer Group: Main Phone")==true){
if(validlength(forMail.contact_name_req.value ,forMail.contact_name_req ,"Employer Group: Primary Contact Name")==true){
if(validlength(forMail.contact_phone_req.value ,forMail.contact_phone_req ,"Employer Group: Phone")==true){
if(validlength(forMail.email_from.value ,forMail.email_from ,"Employer Group: Email")==true){
if(checkemail(forMail.email_from.value,forMail.email_from,"Employer Group: Email")==true){
if(checkRadios(forMail.premium_req.length,forMail.premium_req,"ArmadaCare Plan:","Premium")==true){
if(checkRadios(forMail.maximums_req.length,forMail.maximums_req,"ArmadaCare Plan:","Maximums")==true){
if(checkRadios(forMail.plan_type_req.length,forMail.plan_type_req,"ArmadaCare Plan:","Plan Type")==true){
if(validlength(forMail.effective_month_req.value ,forMail.effective_month_req ,"ArmadaCare Plan: Effective Month")==true){
if(validlength(forMail.effective_year_req.value ,forMail.effective_year_req ,"ArmadaCare Plan: Effective Year")==true){
if(checkRadios(forMail.group_plan_req.length,forMail.group_plan_req,"Underlying Plan:","Group Plan")==true){
if(checkRadios(forMail.group_plan_hmo_req.length,forMail.group_plan_hmo_req,"Underlying Plan:","HMO")==true){
if(validlength(forMail.network_deductible_req.value ,forMail.network_deductible_req ,"Underlying Plan: Network Deductible")==true){
if(checkRadios(forMail.family_deductible_req.length,forMail.family_deductible_req,"Underlying Plan:","Family Deductible")==true){
if(validlength(forMail.co_insurance_req.value ,forMail.co_insurance_req ,"Underlying Plan: Co-Insurance")==true){
if(validlength(forMail.out_pocket_max_req.value ,forMail.out_pocket_max_req ,"Underlying Plan: Out-of-Pocket Maximum")==true){
if(validlength(forMail.drug_co_pay_1_req.value ,forMail.drug_co_pay_1_req ,"Underlying Plan: Drug Co-Pay")==true){
if(checkCensus()==true){
return true;
}}}}}}}}}}}}}}}}}}}}}}}
return false;
}
}