Jason Jordan
48 lines
2.4 KiB
Plaintext
48 lines
2.4 KiB
Plaintext
<div class="bg-deepcove min-h-screen w-full flex flex-col">
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<h1 class="font-bold text-4xl text-platinum">New Employer Setup</h1>
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<h3 class="font-bold text-2xl text-bluemana">Medical Plans</h3>
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<div class="flex flex-col pl-6">
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<%= form_with model: @form, url: employer_setup_index_path, local: true do |f| %>
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<div class="w-full flex my-8">
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<div class="flex flex-col justify-end pr-6">
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<% @id_card_template_benefits.each do |bene| %>
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<%= f.fields_for :benefit_descs do |bd_fields| %>
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<div>
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<%= bd_fields.text_field "#{bene.sequence}", label: { text: "Benefit Description #{bene.sequence}" }, value: "#{bene.benefit_desc}" %>
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</div>
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<% end %>
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<% end %>
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</div>
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<% @form.number_of_plans.to_i.times do |i| %>
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<% border_colors = ['border-atmosphere', 'border-copper', 'border-bluemana'] %>
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<% text_colors = ['text-atmosphere', 'text-copper', 'text-bluemana'] %>
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<div class="inline-flex flex-col justify-end pr-6 pl-1 relative">
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<div class="absolute left-0 top-[2%] h-[98%] border-l-4 <%= border_colors[i] %> rounded-bl-lg"></div>
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<div class="font-bold text-2xl <%= text_colors[i] %> -ml-[6px] z-2 w-full">
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<%= "Plan #{i + 1}" %>
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</div>
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<%= f.fields_for :plans do |plan_fields| %>
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<div class="pl-1 w-full">
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<%= plan_fields.text_field :plan_id, label: { text: "Plan Id" }, class: "w-full" %>
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</div>
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<div class="pl-1" data-controller="benefits_template_picker_controller">
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<%= f.select :template_id, options_from_collection_for_select(@id_card_templates, :id, :name), { prompt: "Select Existing Template (optional)", data: { action: "benefits-template-picker#fetchData" }} %>
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</div>
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<% @id_card_template_benefits.each do |bene| %>
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<div>
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<div class="pl-1 w-full">
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<%= plan_fields.text_field "#{bene.sequence}", label: { text: "Benefit Value #{bene.sequence}" }, data: { benefits_template_picker_target: "benefit_#{bene.sequence}" }, class: "w-full" %>
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</div>
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</div>
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<% end %>
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<% end %>
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</div>
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<% end %>
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</div>
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<div class="py-10">
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<%= f.submit "Continue to Provider Network" %>
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</div>
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<% end %>
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</div>
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</div>
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