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

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

Rate (per day/month) * @error('plan_rate') {{ $message }} @enderror

Annual Rate * @error('annual_plan_rate') {{ $message }} @enderror

Rate Type * @php($rt = old('rate_type', isset($rate->rate_type) ? $rate->rate_type : 'standard')) Standard Medical Condition Family Discount @error('rate_type') {{ $message }} @enderror

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

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

Family Type * @php($ft = old('family_type', isset($rate->family_type) ? $rate->family_type : 'single')) Single Family @error('family_type') {{ $message }} @enderror

Medical Condition Rate @error('medical_condition_rate') {{ $message }} @enderror

Medical Condition Comments @error('medical_condition_comments') {{ $message }} @enderror