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// Step Form Script
var currentStep = 1;
var totalSteps = 16;
var updateProgressBar;
function setOtherStateValues(selectElement){
var selectedOption = selectElement.options[selectElement.selectedIndex];
console.log(selectElement.value);
var rateGroup = selectedOption.getAttribute('data-rate-group');
var stateAbbreviations = selectedOption.getAttribute('data-state-abbreviations');
var templateIds = selectedOption.getAttribute('data-template-id');
$('#rateGroup').val(rateGroup);
$('#stateAbbreviations').val(stateAbbreviations);
$('#template_ids').val(templateIds);
if(selectElement.value=="Pennsylvania" && $('input[name="ProsperityCoverage"]:checked').val()=="yes"){
$('.ProsperityCoverage').show();
}else{
$('.ProsperityCoverage').hide();
}
}
function displayStep(stepNumber) {
// if (stepNumber >= 1 && stepNumber <= 17) {
if (stepNumber >= 1 && stepNumber <= totalSteps) {
// $(".step-" + currentStep).hide();
// $(".step-" + stepNumber).show();
setTimeout(function() {
$(".step").removeClass("animate__animated animate__fadeOutLeft").hide();
$(".step-" + currentStep).show().addClass("animate__animated animate__fadeInRight");
updateProgressBar();
}, 500);
currentStep = stepNumber;
updateProgressBar();
}
}
function showHideMailAddress(){
var mailingAddressValue = $('input[name="mailing_address"]:checked').val();
if(mailingAddressValue === "no"){
$('.mail-address-fields').hide();
$('#MailingStreetAddress').val($('#LegalStreetAddress').val());
$('#MailingCity').val($('#LegalCity').val());
$('#MailingState').val($('#LegalState').val());
$('#MailingZip').val($('#LegalZip').val());
toggleRequiredFields($('.mail-address-fields'), false);
} else {
$('.mail-address-fields').show();
$('#MailingStreetAddress').val("");
$('#MailingCity').val("");
$('#MailingState').val("");
$('#MailingZip').val("");
toggleRequiredFields($('.mail-address-fields'), true);
}
}
$(document).ready(function() {
$('#multi-step-form').find('.step').slice(1).hide();
$(".next-step").click(function() {
var isValid = validateCurrentStep();
if (isValid) {
saveCurrentStepData();
// if (currentStep < 17) {
if (currentStep < totalSteps) {
if((currentStep==6 && $('input[name="electronic_selfbill"]:checked').val()=="SelfBill") ||currentStep==1 ){
$(".step-" + currentStep).addClass("animate__animated animate__fadeOutLeft");
currentStep+=2;
setTimeout(function() {
$(".step").removeClass("animate__animated animate__fadeOutLeft").hide();
$(".step-" + currentStep).show().addClass("animate__animated animate__fadeInRight");
updateProgressBar();
}, 500);
$(this).prop('disabled', false);
}else{
$(".step-" + currentStep).addClass("animate__animated animate__fadeOutLeft");
currentStep++;
setTimeout(function() {
$(".step").removeClass("animate__animated animate__fadeOutLeft").hide();
$(".step-" + currentStep).show().addClass("animate__animated animate__fadeInRight");
updateProgressBar();
}, 500);
}
$(this).prop('disabled', false);
}
}
});
$(".prev-step").click(function() {
if (currentStep > 1) {
if(currentStep==8 && $('input[name="electronic_selfbill"]:checked').val()=="SelfBill"){
$(".step-" + currentStep).addClass("animate__animated animate__fadeOutRight");
currentStep-=2;
setTimeout(function() {
$(".step").removeClass("animate__animated animate__fadeOutRight").hide();
$(".step-" + currentStep).show().addClass("animate__animated animate__fadeInLeft");
updateProgressBar();
}, 500);
}else{
$(".step-" + currentStep).addClass("animate__animated animate__fadeOutRight");
currentStep--;
setTimeout(function() {
$(".step").removeClass("animate__animated animate__fadeOutRight").hide();
$(".step-" + currentStep).show().addClass("animate__animated animate__fadeInLeft");
updateProgressBar();
}, 500);
}
}
});
updateProgressBar = function() {
// var progressPercentage = ((currentStep - 1) / 2) * 100;
var progressPercentage = ((currentStep - 1) / (totalSteps - 1)) * 100;
$(".progress-bar").css("width", progressPercentage + "%");
}
if(($('#saved_progress').val()!="")){
displayStep(Number($('#saved_progress').val())+1);
}
function validateCurrentStep() {
var isValid = true;
var currentStepFields = $(".step-" + currentStep).find("[required], [minlength], [maxlength]");
currentStepFields.each(function () {
var field = $(this);
var fieldType = field.attr('type');
var fieldValue = field.val();
var minLength = field.attr('minlength');
var maxLength = field.attr('maxlength');
if (fieldType === 'radio') {
var radioGroupName = field.attr('name');
if (!$('input[name="' + radioGroupName + '"]:checked').length) {
isValid = false;
highlightField(field);
}
} else if (fieldType === 'checkbox') {
var checkboxGroup = $('input[name="' + field.attr('name') + '"]');
if (!checkboxGroup.is(':checked')) {
isValid = false;
highlightField(field);
} else {
removeHighlight(field);
}
} else {
if (fieldValue.trim().length === 0 || (minLength && fieldValue.length < parseInt(minLength)) || (maxLength && fieldValue.length > parseInt(maxLength))) {
isValid = false;
highlightField(field);
} else {
removeHighlight(field);
}
}
});
return isValid;
}
function highlightField(field) {
field.addClass('highlight-error');
// Scroll to the first invalid field
// $('html, body').animate({
// scrollTop: field.offset().top - 50
// }, 500);
field.one('input change', function () {
removeHighlight(field);
})
}
function removeHighlight(field) {
field.removeClass('highlight-error');
}
});
// End Stepper Script
// Field Hide Show
document.getElementById("PremiumDeductFreq").addEventListener("change", function() {
var pdfSelect = document.getElementById("PremiumDeductFreq");
var pdfSelectOtherInput = document.getElementById("PDFOtherText");
if (pdfSelect.value === "Other") {
pdfSelectOtherInput.style.display = "block";
} else {
pdfSelectOtherInput.style.display = "none";
}
});
document.getElementById("BBABillingFreq").addEventListener("change", function() {
var bbaSelect = document.getElementById("BBABillingFreq");
var bbaSelectOtherInput = document.getElementById("BBAOtherText");
if (bbaSelect.value === "Other") {
bbaSelectOtherInput.style.display = "block";
} else {
bbaSelectOtherInput.style.display = "none";
}
});
const input = document.querySelectorAll(".input");
const inputField = document.querySelector(".inputfield");
const submitButton = document.getElementById("submit");
let inputCount = 0,
finalInput = "";
//Update input
const updateInputConfig = (element, disabledStatus) => {
element.disabled = disabledStatus;
if (!disabledStatus) {
element.focus();
} else {
element.blur();
}
};
input.forEach((element) => {
element.addEventListener("keyup", (e) => {
e.target.value = e.target.value.replace(/[^0-9]/g, "");
let { value } = e.target;
if (value.length == 1) {
updateInputConfig(e.target, true);
if (inputCount <= 6 && e.key != "Backspace") {
finalInput += value;
if (inputCount < 6) {
updateInputConfig(e.target.nextElementSibling, false);
}
}
inputCount += 1;
} else if (value.length == 0 && e.key == "Backspace") {
finalInput = finalInput.substring(0, finalInput.length - 1);
if (inputCount == 0) {
updateInputConfig(e.target, false);
return false;
}
updateInputConfig(e.target, true);
e.target.previousElementSibling.value = "";
updateInputConfig(e.target.previousElementSibling, false);
inputCount -= 1;
} else if (value.length > 1) {
e.target.value = value.split("")[0];
}
submitButton.classList.add("hide");
});
});
window.addEventListener("keyup", (e) => {
if (inputCount > 6) {
submitButton.classList.remove("hide");
submitButton.classList.add("show");
if (e.key == "Backspace") {
finalInput = finalInput.substring(0, finalInput.length - 1);
updateInputConfig(inputField.lastElementChild, false);
inputField.lastElementChild.value = "";
inputCount -= 1;
submitButton.classList.add("hide");
}
}
});
const validateOTP = () => {
alert("Success");
};
//Start
function saveCurrentStepData() {
if (currentStep === totalSteps) { // Only perform validation on the last step
const allFieldsFilled = validateAllFieldsFilled();
if (!allFieldsFilled) {
return;
}
}
const formData = new FormData();
$(".step-" + currentStep + " input[type='hidden'], .step-" + currentStep + " select, .step-" + currentStep + " input.form-control, .step-" + currentStep + " input[type='radio']:checked, .step-" + currentStep + " input[type='checkbox'], .step-" + currentStep + " input[type='file']").each(function() {
const fieldType = $(this).prop('type');
const fieldName = $(this).attr('name');
if (fieldType === 'file') {
formData.append(fieldName, $(this)[0].files[0]);
} else {
let fieldValue;
if (fieldType === 'radio' || fieldType === 'checkbox') {
fieldValue = $(this).is(':checked') ? $(this).val() : '';
} else if (fieldType === 'select-one' || fieldType === 'select-multiple') {
fieldValue = $(this).find('option:selected').val();
} else {
fieldValue = $(this).val();
}
// if (formData.has(fieldName)) {
// console.log({fieldName,fieldValue});
//
// if (!Array.isArray(formData.get(fieldName))) {
// formData.set(fieldName, [formData.get(fieldName)]);
// }
formData.append(fieldName, fieldValue);
// } else {
// formData.set(fieldName, fieldValue);
// }
}
});
formData.set('_token', $('meta[name="csrf-token"]').attr('content'));
formData.set('group_id', $("#group_id").val());
if(currentStep===totalSteps){
$(".step-8 input[type='file'], .step-8 input.form-control").each(function() {
const fieldType = $(this).prop('type');
const fieldName = $(this).attr('name');
const fieldValue = $(this).val();
if (fieldType === 'file') {
formData.append(fieldName, $(this)[0].files[0]);
} else {
// For non-file inputs (assuming they are for medical plan names)
if (fieldName === 'G3MedicalPlanName' ||
fieldName === 'G1MedicalPlanName' ||
fieldName === 'G2MedicalPlanName') {
formData.append(fieldName, fieldValue);
}
}
});
$(".step-11 input[type='file']").each(function() {
const fieldType = $(this).prop('type');
const fieldName = $(this).attr('name');
const fieldValue = $(this).val();
formData.append(fieldName, $(this)[0].files[0]);
});
}
$('#submitButton').prop("disabled", true);
$('#submitButton').text("saving...");
console.log(formData);
$.ajax({
url: '/save-current-step-data',
method: 'POST',
data: formData,
processData: false, // Prevents jQuery from automatically processing the data
contentType: false, // Prevents jQuery from automatically setting the content type
success: function(response) {
$('#submitButton').prop("disabled", false);
$('#submitButton').html(" Submit");
console.log('Step data saved successfully');
$("#group_id").val(response.group_id);
$("#item" + response.currentStep).val(response.item_id);
toastr.success('Progress Saved Successfully!')
toastr.options.closeDuration = 50;
if (response.currentStep == totalSteps) {
Swal.fire({
title: "Intake Complete!",
html: "Thank you for submitting your group paperwork!
" +
"You will soon receive an email containing a link to confirm and sign the documents.
" +
"Once completed, a member of our NAS Agent Concierge Team will review your submission for processing.
" +
"If you encounter any issues or do not receive the email, please reach out to our agent Concierge team at"+
"
sales@nationalagencysolutions.com
or
+1 (866) 744 1531.",
icon: "success",
showConfirmButton: false,
allowOutsideClick: false,
footer: ''
});
document.getElementById('goToDashboard').onclick = function() {
window.location.href = "/dashboard";
};
}
},
error: function(xhr, status, error) {
$('#submitButton').prop("disabled", false);
$('#submitButton').html(" Submit");
console.error('Error saving step data:', error);
toastr.error('Something Went Wrong!')
}
});
}
function handleStep12() {
var formData = new FormData();
// Collect values from input fields
var userFirstName = [];
var userEmail = [];
var userCheck1 = [];
var userCheck2 = [];
var userCheck3 = [];
Array.from(document.querySelectorAll('input[name="UserFirstName\\[\\]"]')).forEach(function(input) {
userFirstName.push(input.value);
});
Array.from(document.querySelectorAll('input[name="UserEmailAddress\\[\\]"]')).forEach(function(input) {
userEmail.push(input.value);
});
Array.from(document.querySelectorAll('select[name="userEmployed\\[\\]"]')).forEach(function(select) {
userCheck1.push(select.value);
});
Array.from(document.querySelectorAll('select[name="userEligible\\[\\]"]')).forEach(function(select) {
userCheck2.push(select.value);
});
Array.from(document.querySelectorAll('select[name="userBalance\\[\\]"]')).forEach(function(select) {
userCheck3.push(select.value);
});
// Rearrange data
for (var i = 0; i < userFirstName.length; i++) {
var obj = {
'UserFirstName': userFirstName[i],
'userEmail': userEmail[i],
'userEmployed': userCheck1[i] || 'no',
'userEligible': userCheck2[i] || 'no',
'userBalance': userCheck3[i] || 'no'
};
// Append each key-value pair to formData
for (var key in obj) {
formData.append(key, obj[key]);
}
}
// Add CSRF token and group ID
formData.append('_token', document.querySelector('meta[name="csrf-token"]').getAttribute('content'));
formData.append('group_id', document.getElementById("group_id").value);
$.ajax({
url: '/save-current-step-data',
method: 'POST',
data: formData,
processData: false, // Prevents jQuery from automatically processing the data
contentType: false, // Prevents jQuery from automatically setting the content type
success: function(response) {
$('#submitButton').prop("disabled", false);
$('#submitButton').html(" Submit");
console.log('Step data saved successfully');
$("#group_id").val(response.group_id);
$("#item" + response.currentStep).val(response.item_id);
toastr.success('Progress Saved Successfully!');
toastr.options.closeDuration = 50;
},
error: function(xhr, status, error) {
$('#submitButton').prop("disabled", false);
$('#submitButton').html(" Submit");
console.error('Error saving step data:', error);
toastr.error('Something Went Wrong!');
}
});
}
function showlocations(obj) {
var value;
if (obj) {
if ($(obj).val() === 'SeparateBill') {
// If obj is passed and its value is 'SeparateBill',
// get the value from the dropdown directly
value = $('select[name="how_many_location"]').val();
} else {
// Otherwise, get the value from obj
value = $(obj).val();
}
} else {
// If obj is not passed, get the value from the dropdown directly
value = $('select[name="how_many_location"]').val();
}
for (var i = 2; i <= 10; i++) {
if (value >= i) {
$(`#location_${i}`).show().find('input, input[type="radio"]').prop('required', true);
} else {
$(`#location_${i}`).hide().find('input, input[type="radio"]').prop('required', false);
}
}
}
function showClasses(obj){
var value = $(obj).val();
if(value==3){
$('#class_2').show().find('input, input[type="radio"]').prop('required', true);
$('#class_3').show().find('input, input[type="radio"]').prop('required', true);
}else if (value==2){
$('#class_2').show().find('input, input[type="radio"]').prop('required', true);
$('#class_3').hide().find('input, input[type="radio"]').prop('required', false);
}else{
$('#class_2').hide().find('input, input[type="radio"]').prop('required', false);
$('#class_3').hide().find('input, input[type="radio"]').prop('required', false);
}
}
function showHide(id, obj) {
var $obj = $(obj);
if ($obj.is(':radio') || $obj.is(':checkbox')) {
switch (id) {
case 'ProsperityCoverage':
$('.' + id).toggle($obj.is(':checked') && ($obj.val() == 'yes') && ($('#current-state').val()=="Pennsylvania"));
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'yes' && $('#current-state').val()=="Pennsylvania");
upDateFileds(obj)
break;
case 'CDOther':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'yes');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'no');
break;
case 'AllCoverageSold':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'no');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'no');
break;
case 'separate_benefit_contact':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'yes');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'yes');
break;
case 'separate_billing_contact':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'yes');
upDateFiledsBillings(obj)
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'yes');
break;
case 'how_many_location':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'SeparateBill');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'yes');
break;
case 'OtherLocation':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'yes');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'yes');
break;
case 'WrittenGeneralAgency':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'yes');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'yes');
break;
case 'plan2':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'yes');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'yes');
break;
case 'plan3':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'yes');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'yes');
break;
case 'retiredClass':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'yes');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'yes');
break;
case 'NumberOfClasses':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'yes');
if($('input[name="ClassInfo"]:checked').val()=="no"){
console.log('yes');
$('#class_1').hide();
$('#class_2').hide();
$('#class_3').hide();
toggleRequiredFields($(".class_1"), false);
toggleRequiredFields($('.' + id), false);
}else{
console.log('no');
$('#NumberOfClasses').val(1);
$('#class_1').show();
toggleRequiredFields($(".class_1"), true);
toggleRequiredFields($('.' + id), true);
}
break;
case 'SexType':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'yes');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'yes');
break;
case 'CensusEnrollment':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'edi');
$('.CensusEnrollment1').toggle($obj.is(':checked') && $obj.val() != 'edi');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'edi');
toggleRequiredFields('.CensusEnrollment1', $obj.is(':checked') && $obj.val() != 'edi');
break;
case 'CobraSection':
if($('input[name="CobraInfo"]:checked').val()=="yes"){
$('#CobraSection').show();
}else{
$('#CobraSection').hide();
toggleRequiredFields($('#CobraSection'), false);
}
break;
case 'COBRAAdministration':
$('.' + id).toggle($obj.is(':checked') && $obj.val() == 'ThirdPartyAdministered');
toggleRequiredFields($('.' + id), $obj.is(':checked') && $obj.val() == 'ThirdPartyAdministered');
break;
case 'anniversary_date':
if($('input[name="CafeteriaPlan"]:checked').val()=="yes"){
$('#anniversary_date').show();
}else{
$('#anniversary_date').hide();
toggleRequiredFields($('#anniversary_date'), false);
}
break;
case 'benefit-fields':
$(obj).closest('.locationDublicateClass').find('.' + id).toggle($obj.is(':checked') && $obj.val() == 'Yes');
toggleRequiredFields($(obj).closest('.locationDublicateClass').find('.' + id), $obj.is(':checked') && $obj.val() == 'Yes');
populatBenifitFields(obj);
break;
case 'orgTypeOther':
if($('input[name="OrganizationType"]:checked').val()=="Other"){
$('#orgTypeOther').show();
}else{
$('#orgTypeOther').hide();
}
case 'electronic_selfbill_div':
if($obj.is(':checked') && $obj.val() == 'SelfBill'){
$('.' + id).show();
toggleRequiredFields($('.' + id), true);
}else{
$('.' + id).hide();
toggleRequiredFields($('.' + id), false);
}
break;
default:
$('.' + id).hide();
toggleRequiredFields($('.' + id), false);
}
}
else if ($obj.is('select')) {
switch (id) {
case 'PDFOtherText':
var val = $obj.val();
$('.' + id).toggle(val == 'Other' || val == 'BiWeekly' || val == 'Weekly');
$('.PDFPayPeriodStart').toggle(val == 'Other' || val == 'BiWeekly' || val == 'Weekly');
toggleRequiredFields($('.' + id), val == 'Other' || val == 'BiWeekly' || val == 'Weekly');
toggleRequiredFields($('.PDFPayPeriodStart'), val == 'Other' || val == 'BiWeekly' || val == 'Weekly');
break;
case 'BBAOtherText':
$('.' + id).toggle($obj.val() == 'Other');
toggleRequiredFields($('.' + id), $obj.val() == 'Other');
break;
default:
$('.' + id).hide();
toggleRequiredFields($('.' + id), false);
}
} else {
console.error("Object is neither a checkbox, radio button, nor a select element.");
}
}
function validatePlanName(input) {
var planNameInputs = document.querySelectorAll('.planName');
var planNames = Array.from(planNameInputs).map(function(input) {
return input.value.trim().toLowerCase();
});
var index = Array.from(planNameInputs).indexOf(input);
if (index !== -1) {
planNames.splice(index, 1);
}
var inputValue = input.value.trim().toLowerCase();
var isDuplicate = planNames.includes(inputValue);
if (isDuplicate) {
alert('Plan name must be unique.');
input.value = '';
input.focus();
}
}
function dublicateDiv(obj,id,className){
var count = parseInt(obj.value);
console.log(count);
var container = document.getElementById(id);
var originalDiv = document.querySelector("."+className);
container.innerHTML = '';
for (var i = 0; i < count; i++) {
var clone = originalDiv.cloneNode(true);
clone.style.display = "block"; // Show the cloned div
container.appendChild(clone);
}
}
function upDateFileds(obj){
console.log($(obj).val());
if($(obj).val()=='no'){
var execContactName = $('#ExecutiveContactName').val();
var execTitle = $('#ExecutiveTitle').val();
var execEmailAddress = $('#ExecutiveEmailAddress').val();
var execPhoneNumber = $('#ExecutivePhoneNumber').val();
// Set values in corresponding benefit fields
$('#BenefitContactName').val(execContactName);
$('#BenefitTitle').val(execTitle);
$('#BenefitEmailAddress').val(execEmailAddress);
$('#BenefitPhoneNumber').val(execPhoneNumber);
} else {
// Empty the benefit fields
$('#BenefitContactName').val('');
$('#BenefitTitle').val('');
$('#BenefitEmailAddress').val('');
$('#BenefitPhoneNumber').val('');
}
}
function upDateFiledsBillings(obj){
if($(obj).val()=='no'){
var execContactName = $('#ExecutiveContactName').val();
var execTitle = $('#ExecutiveTitle').val();
var execEmailAddress = $('#ExecutiveEmailAddress').val();
var execPhoneNumber = $('#ExecutivePhoneNumber').val();
// Set values in corresponding benefit fields
$('#BillingContactName').val(execContactName);
$('#BillingTitle').val(execTitle);
$('#BillingEmailAddress').val(execEmailAddress);
$('#BillingPhoneNumber').val(execPhoneNumber);
} else {
// Empty the benefit fields
$('#BillingContactName').val('');
$('#BillingTitle').val('');
$('#BillingEmailAddress').val('');
$('#BillingPhoneNumber').val('');
}
}
function populatBenifitFields(obj){
if($(obj).val() == 'No'){
var l2BenefitContactName = $(obj).closest('.locationDublicateClass').find('#L2BenefitContactName').val();
var l2BenefitTitle = $(obj).closest('.locationDublicateClass').find('#L2BenefitTitle').val();
var l2BenefitEmail = $(obj).closest('.locationDublicateClass').find('#L2BenefitEmail').val();
var l2BenefitPhone = $(obj).closest('.locationDublicateClass').find('#L2BenefitPhone').val();
$(obj).closest('.locationDublicateClass').find('#L3BenefitContactName').val(l2BenefitContactName);
$(obj).closest('.locationDublicateClass').find('#L3BenefitTitle').val(l2BenefitTitle);
$(obj).closest('.locationDublicateClass').find('#L3BenefitEmail').val(l2BenefitEmail);
$(obj).closest('.locationDublicateClass').find('#L3BenefitPhone').val(l2BenefitPhone);
} else {
$(obj).closest('.locationDublicateClass').find('#L3BenefitContactName').val('');
$(obj).closest('.locationDublicateClass').find('#L3BenefitTitle').val('');
$(obj).closest('.locationDublicateClass').find('#L3BenefitEmail').val('');
$(obj).closest('.locationDublicateClass').find('#L3BenefitPhone').val('')
}
;
}
function addFields(obj) {
console.log('test');
var $formGroup = $(obj).closest(".form-group");
var $newFormGroup = $formGroup.clone();
$newFormGroup.find('input[type="text"]').val('');
$newFormGroup.find('input[type="email"]').val('');
$newFormGroup.find('textarea').val('');
$formGroup.after($newFormGroup);
updateButtonStates();
}
function removeFields(obj) {
var $formGroup = $(obj).closest(".form-group");
$formGroup.remove();
updateButtonStates();
}
function updateButtonStates() {
var $formGroups = $(".form-group");
var numFields = $formGroups.length;
$(".add-btn").prop("disabled", numFields >= 16);
$(".remove-btn").prop("disabled", numFields <= 1);
}
function validatePercentage(input) {
let value = parseFloat(input.value);
if (value > 100) {
input.value = 100;
}
}
function getDollarTiers(plan) {
var employees = $('#EligibleEEMembers').val();
var rateGroup = $('#rateGroup').val();
var stateAbbreviation = $('#stateAbbreviations').val();
var state = $('#current-state').val();
var deductibleAmountField = '#' + plan + 'DeductibleAmount';
var povFieldName;
switch (plan) {
case 'plan1':
povFieldName = 'GroupPlan1';
break;
case 'plan2':
povFieldName = 'GroupPlan2';
break;
case 'plan3':
povFieldName = 'GroupPlan3';
break;
default:
console.error('Invalid plan:', plan);
return; // Exit function for invalid plan
}
var deductibleAmount = $(deductibleAmountField).val();
var povValue = $('input[name="' + povFieldName + '"]:checked').val();
if(plan=='plan1' && povValue=="G1POV"){
$("input[name='PhysicianOfficeVisits']").prop("checked", true);
$("input[name='IncludesChiropracticServices']").prop("checked", true);
}else{
$("input[name='PhysicianOfficeVisits']").prop("checked", false);
$("input[name='IncludesChiropracticServices']").prop("checked", false);
}
if(povValue!=null && deductibleAmount!=null){
NProgress.start();
$('#overlay').show();
// Get CSRF token value
var csrfToken = $('meta[name="csrf-token"]').attr('content');
// Prepare data object
var data = {
deductibleAmount: deductibleAmount,
employees: employees,
state: state,
povValue: povValue,
rateGroup:rateGroup,
stateAbbreviation:stateAbbreviation
};
$.ajax({
url: '/get-dollars',
method: 'POST',
headers: {
'X-CSRF-TOKEN': csrfToken
},
data: data,
success: function(response) {
var benefitAmountField = '#' + plan + 'BenefitAmount';
var $benefitAmount = $(benefitAmountField).empty();
$benefitAmount.append($('