@extends('layouts.app')

@section('title', 'Add BPJS')

@section('content')
<div class="row">
    <div class="col-md-8">
        <div class="card">
            <div class="card-header d-flex justify-content-between align-items-center">
                <h5 class="mb-0"><i class="bi bi-shield-plus me-2"></i>Add New BPJS</h5>
                <a href="{{ route('bpjs.index') }}" class="btn btn-secondary">
                    <i class="bi bi-arrow-left me-1"></i> Back
                </a>
            </div>
            <form action="{{ route('bpjs.store') }}" method="POST">
                @csrf
                <div class="card-body">
                    <div class="row">
                        <div class="col-md-6 mb-3">
                            <label for="employee_id" class="form-label">Employee <span class="text-danger">*</span></label>
                            <select class="form-select @error('employee_id') is-invalid @enderror" id="employee_id" name="employee_id" required>
                                <option value="">Select Employee</option>
                                @foreach($employees as $employee)
                                    <option value="{{ $employee->id }}" {{ old('employee_id') == $employee->id ? 'selected' : '' }}>
                                        {{ $employee->name }}
                                    </option>
                                @endforeach
                            </select>
                            @error('employee_id')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <div class="col-md-6 mb-3">
                            <label for="bpjs_type" class="form-label">BPJS Type <span class="text-danger">*</span></label>
                            <select class="form-select @error('bpjs_type') is-invalid @enderror" id="bpjs_type" name="bpjs_type" required>
                                <option value="">Select Type</option>
                                <option value="bpjskes" {{ old('bpjs_type') == 'bpjskes' ? 'selected' : '' }}>BPJS Kesehatan</option>
                                <option value="bpjstk" {{ old('bpjs_type') == 'bpjstk' ? 'selected' : '' }}>BPJS Ketenagakerjaan</option>
                            </select>
                            @error('bpjs_type')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <div class="col-md-12 mb-3">
                            <label for="bpjs_number" class="form-label">BPJS Number <span class="text-danger">*</span></label>
                            <input type="text" class="form-control @error('bpjs_number') is-invalid @enderror" id="bpjs_number" name="bpjs_number" value="{{ old('bpjs_number') }}" required maxlength="50">
                            @error('bpjs_number')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <div class="col-md-6 mb-3">
                            <label for="contribution_company" class="form-label">Company Contribution (%)</label>
                            <div class="input-group">
                                <input type="number" class="form-control @error('contribution_company') is-invalid @enderror" id="contribution_company" name="contribution_company" value="{{ old('contribution_company', '0') }}" min="0" max="100" step="0.01">
                                <span class="input-group-text">%</span>
                            </div>
                            @error('contribution_company')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <div class="col-md-6 mb-3">
                            <label for="contribution_employee" class="form-label">Employee Contribution (%)</label>
                            <div class="input-group">
                                <input type="number" class="form-control @error('contribution_employee') is-invalid @enderror" id="contribution_employee" name="contribution_employee" value="{{ old('contribution_employee', '0') }}" min="0" max="100" step="0.01">
                                <span class="input-group-text">%</span>
                            </div>
                            @error('contribution_employee')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>

                        <div class="col-md-12 mb-3">
                            <label for="status" class="form-label">Status <span class="text-danger">*</span></label>
                            <select class="form-select @error('status') is-invalid @enderror" id="status" name="status" required>
                                <option value="1" {{ old('status', '1') == '1' ? 'selected' : '' }}>Active</option>
                                <option value="0" {{ old('status') == '0' ? 'selected' : '' }}>Inactive</option>
                            </select>
                            @error('status')
                                <div class="invalid-feedback">{{ $message }}</div>
                            @enderror
                        </div>
                    </div>
                </div>
                <div class="card-footer text-end">
                    <a href="{{ route('bpjs.index') }}" class="btn btn-outline-secondary me-2">Cancel</a>
                    <button type="submit" class="btn btn-primary">
                        <i class="bi bi-check-lg me-1"></i> Save BPJS
                    </button>
                </div>
            </form>
        </div>
    </div>
</div>
@endsection