HTC - Enrollments Form UI Prototype Contest

Humana is managed health care company that markets and administers health insurance. Humana and TopCoder (HTC) have teamed up to convert internal Humana's application that is called Enrollment Form to use another technology. This web-based application will be used by our agent for registering our customer. The first step is to redesign this application so it will have better user experience. In this contest we need your help to convert the storyboard we already get into working prototype.

Please review the contest document, it is attached in Download Section in this page, you need to register the contest to download it. There are 2 pages you need to create, they are index.html and review.html. The former will contains infomation from screen Select state, Select Employer or Employee, Select Plan Type and Select form type. The latter will contains information from screen Review. Following are details information about prototype functionality:

• Ignore Humana's header, it is not required.
• Refer screen Select State. This is the first screen user will see. In this screen there is a drop down box that contain a State to be choosen. When user check the checkbox, user will be shown next form below it, see screen Select Employer or Employee.
• Refer screen Select Employer or Employee. All radio button is in one group. When user selects item Modify, shows a dropdown box next to the item. After users choose one of items, they will be shown next form below it, see screen Select Plan Type.
• Refer screen Select Plan Type. Life children items must be enabled when Life is checked, otherwise they are disabled. Coverage amount per person value must be grouped in thousand. Total number of employee value also must be grouped in thousand and decimal value is not allowed. When user clicks Continue, current form must be collapsed and Select Form Type must be expanded.
• Refer screen Select Form Type. User must choose options in this step, this should be validated. Each groups of option is expandable/collapsable. Employee Enrollment Application items are same with Employer Group Application items. Other Employee Forms (continuation, etc) items is same with Other Employer Forms items. When Regulatory Forms collapse, hide List Enrollment Spreadsheet and its description, expand it otherwise. When user clicks Continue, bring user to review.html page.
• Step number in the right corner must match the current active step.
• When user clicks Back in each step, bring user to previous step.
• Refer step State & Plan. Highlight the form when user hover on it. As you may noticed, there are 3 forms type in this step.

MAKE SURE TO WATCH CONTEST FORUM FOR ANY ADDITIONAL REQUIREMENTS AND CLARIFICATIONS THAT MAY BE ISSUED.

Final Submission Guidelines

Following are specific requirements for HTML, CSS and Javascript files:

• Your HTML code must be XHTML 1.0 Strict compliant
• Validate your code, reviewers may accept minor validation errors, but please comment your reason for any validation errors. Use the validators listed in the scorecard.
• Use CSS to space out objects, not clear/transparent images (GIFs or PNGs) and use proper structural CSS to lay out your page. Only use table tags for tabular data and not for page layout.
• No inline CSS styles, all styles must be placed in an external stylesheet.
• Use semantically correct tags - use H tags for headers, etc. Use strong and em tags instead of bold and italic tags.
• Element and Attribute names should be in lowercase and use a "-" or camel naming to separate multiple-word classes (i.e. "main-content", or "mainContent".
• All JavaScript must not have a copyright by a third party. You are encouraged to use your own scripts, or scripts that are free, publicly available and do not have copyright statements or author recognition requirements anywhere in the code. You are allowed to use the JQuery JavaScript library for this contest.

Your submission must works on browser in the list below:

• IE7+
• FF 3+ Mac & PC
• Safari 4 Mac & PC
• Chrome Mac & PC
• Opera Mac & PC

Submit an archive file contains all HTML/CSS/JS/images and another required files into Online Review.