<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css">
<script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script>
<script src="//code.jquery.com/jquery-1.11.1.min.js"></script>
<form class="form-horizontal">
<fieldset>
<legend>Login</legend>
<div class="form-group">
<label class="col-md-4 control-label" for="txtUsername">Aetna ID</label>
<div class="col-md-3">
<input name="txtUsername" class="form-control input-md" id="txtUsername" required="" type="text" placeholder="">
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label" for="txtPassword">Password</label>
<div class="col-md-3">
<input name="txtPassword" class="form-control input-md" id="txtPassword" required="" type="password" placeholder="">
</div>
</div>
<div class="form-group">
<label class="col-md-4 control-label" for="btnLogin"></label>
<div class="col-md-4">
<button name="btnLogin" class="btn btn-primary" id="btnLogin">Login</button>
</div>
</div>
