Plan * Select Plan @foreach ($plans as $p) plan_id) ? $deductible->plan_id : ($selectedPlanId ?? '')) == $p->id)> {{ $p->name }} ({{ optional($p->provider)->display_name ?? optional($p->provider)->name }}) @endforeach @error('plan_id') {{ $message }} @enderror

Type * @php($dt = old('deductible_type', isset($deductible->deductible_type) ? $deductible->deductible_type : ($prefillType ?? 'flat'))) Flat Percentage Amount Based @error('deductible_type') {{ $message }} @enderror

Value * @error('deductible_value') {{ $message }} @enderror

Benefit Amount @error('benefit_amount') {{ $message }} @enderror

Age Start @error('age_range_start') {{ $message }} @enderror

Age End @error('age_range_end') {{ $message }} @enderror

Age 70 Rate @error('age_70_rate') {{ $message }} @enderror

Age 70+ Rate @error('age_70_up_rate') {{ $message }} @enderror

Age 80+ Rate @error('age_80_up_rate') {{ $message }} @enderror

Discount Age 0-70 @error('age_0_70_discount') {{ $message }} @enderror

Discount Age 70+ @error('age_70_up_discount') {{ $message }} @enderror

$3000 Rate

$1000 Rate

$500 Rate

$100 Rate

$0 Rate