New Employer Setup

Provider Network

<%= form_with model: @form, url: employer_setup_index_path, local: true do |f| %> <% @form.number_of_additional_network_logos.to_i.times do |i| %> <%= f.fields_for :network_exceptions do |network_fields| %>
No file chosen <%= network_fields.file_field :network_logo, class: "hidden", id: "file_upload_input" %>
<% 2.to_i.times do |j| %> <%= network_fields.fields_for :exceptions do |exception_fields| %>
<%= exception_fields.select :type, options_for_select(["Zipcode","State"]), label: { text: "Exception Type" }, prompt: "Select Type", class: "w-full" %>
<%= exception_fields.text_field :value, label: { text: "Exception Value" }, class: "w-full" %>
<% end %> <% end %>
<% end %> <% end %>
<%= f.submit "Continue to Summary" %>
<% end %>