<%= f.text_field :name, label: { text: "Employer Name" }, class: "w-full" %>
<%= f.text_field :slug, label: { text: "Slug" }, class: "w-full" %>
<%= f.text_field :pl_plan_key, label: { text: "Pl Plan Key" }, class: "w-full" %>
<%= f.text_field :group_number, label: { text: "Group/Medical Number" }, class: "w-full" %>
<%= f.text_field :effective_date, label: { text: "Effective Date" }, class: "w-full" %>