128 lines
8.9 KiB
Plaintext
128 lines
8.9 KiB
Plaintext
<div class="bg-deepcove h-full w-full flex flex-col">
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<h1 class="font-bold text-4xl text-platinum my-5">Edit Employer</h1>
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<%= form_with model: @employer, local: true, multipart: true do |f| %>
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<div class="flex flex-col space-y-6">
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<div class="w-full flex items-center">
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<h3 class="font-bold text-2xl text-bluemana">General Information</h3>
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<div class="h-[1px] w-1/2 mt-2 bg-bluemana"></div>
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</div>
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<div class="flex w-full items-end" data-controller="logo-upload">
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<div class="flex flex-col space-y-6 w-3/5">
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<div class="flex space-x-10">
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<div class="w-full">
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<%= f.text_field :name, label: { text: "Employer Name" }, class: "w-full" %>
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</div>
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<div class="w-full">
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<%= f.text_field :slug, label: { text: "Slug" }, class: "w-full" %>
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</div>
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<div class="w-full">
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<%= f.text_field :group_number, label: { text: "Group/Medical Number" }, class: "w-full" %>
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</div>
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</div>
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<div class="flex space-x-10">
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<div class="w-full">
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<%= f.text_field :pl_plan_key, label: { text: "Pl Plan Key" }, class: "w-full" %>
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</div>
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<div class="w-full">
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<%= f.text_field :effective_date, label: { text: "Effective Date" }, class: "w-full" %>
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</div>
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<div class="w-full">
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<%= f.select :network_provider, options_for_select(["Cigna", "Medcost"]), label: { text: "Provider Network" }, class: "w-full" %>
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</div>
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</div>
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<div class="flex items-end">
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<div class="flex flex-col">
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<%= f.text_field :employer_logo_filename, data: { logo_upload_target: "logofield" }, class: "w-full rounded-r-none", readonly: true %>
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</div>
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<div class="flex items-center justify-center cursor-pointer bg-atmosphere hover:bg-deepcove border-2 border-atmosphere text-platinum font-bold px-3 rounded-r h-10 transition duration-100">
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<label for="file_upload_input_employer" class="text-center cursor-pointer">
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<%= icon "image-plus", library: "lucide" %>
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</label>
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</div>
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<div class="hidden flex justify-center ml-15 rounded-lg border-4 border-atmosphere" data-logo-upload-target="previewContainer">
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<img data-logo-upload-target="preview" src="#" alt="Employer Logo preview" class="max-h-[100px] max-w-[133px] bg-platinum m-1"/>
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</div>
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<%= f.file_field :add_or_update_logo, class: "hidden", id: "file_upload_input_employer", data: { logo_upload_target: "previewContainer", logo_upload_type_param: "employer", action: "change->logo-upload#uploadLogo" }, direct_upload: true %>
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</div>
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</div>
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</div>
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<div class="w-full flex items-center">
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<h3 class="font-bold text-2xl text-bluemana">Plans Information</h3>
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<div class="h-[1px] w-1/2 mt-2 bg-bluemana"></div>
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</div>
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<div class="w-full flex my-8" data-controller="add-plan" data-add-plan-form-color-value="<%= IdCard::Configuration::FORM_COLORS.to_json %>" >
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<div class="flex flex-wrap w-full" data-add-plan-target="container">
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<% @employer.plans.each_with_index do |plan, index| %>
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<%= f.fields_for :plans, plan, child_index: index do |plan_fields| %>
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<div class="inline-flex flex-col pr-6 w-1/4 relative pl-1" data-controller="benefits-template-picker">
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<div class="absolute left-0 top-[2%] h-[98%] border-l-4 <%= "border-#{IdCard::Configuration::FORM_COLORS[index]}" %>"></div>
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<div class="font-bold text-2xl <%= "text-#{IdCard::Configuration::FORM_COLORS[index]}" %> -ml-[6px] z-2 w-full">
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<%= "Plan #{index + 1}" %>
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</div>
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<%= render 'plan_fields', plan_fields: plan_fields, f: f, index: index %>
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<div class="text-xl text-left font-bold pl-[2px] mb-[-4px] z-1 <%= "text-#{IdCard::Configuration::FORM_COLORS[index]}" %>">
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Benefit Values
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</div>
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<div class="w-full h-[3px] rounded-r <%= "bg-#{index % 2 == 1 ? 'bronze' : 'copper'}" %> ml-[3px]"></div>
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<%= plan_fields.fields_for :plan_benefits do |plan_benefits_fields| %>
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<%= render 'plan_benefits_fields', plan_benefits_fields: plan_benefits_fields %>
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<% end %>
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<div class="mt-4 pl-1">
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<%= plan_fields.hidden_field :_destroy %>
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<%= button_tag "Remove Plan #{index + 1}", class: "cursor-pointer bg-deepcove hover:bg-brightlava text-xl font-bold text-#{index % 2 == 1 ? 'bronze' : 'copper'} hover:text-platinum py-2 px-4 font-semibold leading-tight rounded-lg border-3 border-NEXT_SECONDARY_COLOR w-full", data: { action: "add-plan#remove" } %>
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</div>
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</div>
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<% end %>
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<% end %>
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<%= button_tag "Add a Plan", class: "cursor-pointer text-2xl font-bold py-2 pr-6 mt-10 w-[calc(24%-1rem)] w-1/4 min-h-[940px] text-[#E0E0E0] rounded-lg font-medium border border-[#E0E0E0] bg-[#173057] hover:bg-transparent hover:shadow-[0_0_10px_3px_#93c5fd] transition-colors duration-150", data: { action: "add-plan#add", add_plan_target: "button" } %>
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<template data-add-plan-target="template">
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<%= f.fields_for :plans, @employer.build_plan_with_default_benefits, child_index: 'NEW_RECORD' do |plan_fields| %>
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<div class="inline-flex flex-col justify-end pr-6 w-1/4 relative pl-1" data-controller="benefits-template-picker">
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<div class="absolute left-0 top-[2%] h-[98%] border-l-4 border-NEXT_COLOR"></div>
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<div class="font-bold text-2xl text-NEXT_COLOR -ml-[6px] z-2 w-full">
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<%= "Plan NEW_PLAN" %>
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</div>
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<%= render 'plan_fields', plan_fields: plan_fields, f: f, index: "NEW_RECORD".to_i %>
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<div class="text-xl text-left font-bold pl-[2px] mb-[-4px] z-1 text-NEXT_COLOR">
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Benefit Values
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</div>
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<div class="w-full h-[3px] rounded-r bg-NEXT_SECONDARY_COLOR ml-[3px]"></div>
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<%= plan_fields.fields_for :plan_benefits do |plan_benefits_fields| %>
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<%= render 'plan_benefits_fields', plan_benefits_fields: plan_benefits_fields %>
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<% end %>
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<div class="mt-4 pl-1">
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<%= plan_fields.hidden_field :_destroy %>
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<%= button_tag "Remove Plan NEW_PLAN", class: "cursor-pointer bg-deepcove hover:bg-brightlava text-xl font-bold text-NEXT_SECONDARY_COLOR hover:text-platinum py-2 px-4 font-semibold leading-tight rounded-lg border-3 border-NEXT_SECONDARY_COLOR w-full", data: { action: "add-plan#remove" } %>
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</div>
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</div>
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<% end %>
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</template>
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</div>
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</div>
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<div class="w-full flex items-center">
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<h3 class="font-bold text-2xl text-bluemana">Alternative Network Information</h3>
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<div class="h-[1px] w-1/2 mt-2 bg-bluemana"></div>
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</div>
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<div class="flex w-full justify-start" data-controller="add-alt-network-logo" data-add-alt-network-logo-form-color-value="<%= IdCard::Configuration::FORM_COLORS.to_json %>">
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<div class="flex flex-wrap w-full" data-add-alt-network-logo-target="container">
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<%= button_tag "Add a Regional Logo", class: "cursor-pointer text-lg font-medium py-2 px-4 rounded w-1/7 h-75 my-8 text-[#E0E0E0] rounded-lg border border-[#C2C2C2] hover:shadow-[0_0_10px_3px_#93c5fd]", data: { action: "add-alt-network-logo#add", add_alt_network_logo_target: "button" } %>
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</div>
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<template data-add-alt-network-logo-target="template">
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<%= f.fields_for :alternate_network_logos, AlternateNetworkLogo.new, child_index: 'NEW_RECORD' do |network_fields| %>
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<div class="flex flex-col my-8 mr-3 space-y-6 px-3" data-controller="add-network-exception" data-add-network-exception-parent-color-value="NEXT_SECONDARY_COLOR">
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<%= render 'alt_network_logo_fields', network_fields: network_fields, f: f %>
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</div>
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<% end %>
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</template>
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</div>
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<div class="flex py-8 space-x-4">
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<%= f.submit "Submit" %>
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<%= link_to "Back", employer_path(@employer.slug), class: "flex justify-center items-center cursor-pointer bg-atmosphere hover:bg-deepcove border-2 border-atmosphere text-platinum font-bold px-3 rounded-sm h-10 transition duration-100" %>
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</div>
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</div>
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<% end %>
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</div>
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