example code in PHP and HTML that you can use to implement a similar functionality of checking prices and displaying benefits for insurance and health plans, and sending them via email
<!DOCTYPE html>
<html>
<head>
<title>Check Insurance and Health Plan Prices</title>
</head>
<body>
<h1>Check Insurance and Health Plan Prices</h1>
<form method="post" action="">
<label for="insurance_price">Insurance Price:</label>
<input type="text" name="insurance_price" id="insurance_price"><br><br>
<label for="health_plan_price">Health Plan Price:</label>
<input type="text" name="health_plan_price" id="health_plan_price"><br><br>
<label for="insurance_benefits">Insurance Benefits:</label><br>
<textarea name="insurance_benefits" id="insurance_benefits" rows="5" cols="50"></textarea><br><br>
<label for="health_plan_benefits">Health Plan Benefits:</label><br>
<textarea name="health_plan_benefits" id="health_plan_benefits" rows="5" cols="50"></textarea><br><br>
<label for="email">Email:</label>
<input type="email" name="email" id="email"><br><br>
<input type="submit" name="submit" value="Submit">
</form>
<?php
if(isset($_POST['submit'])){
$to = $_POST['email'];
$subject = "Insurance and Health Plan Prices";
$message = "Insurance Price: ".$_POST['insurance_price']."\n";
$message .= "Insurance Benefits: ".$_POST['insurance_benefits']."\n\n";
$message .= "Health Plan Price: ".$_POST['health_plan_price']."\n";
$message .= "Health Plan Benefits: ".$_POST['health_plan_benefits']."\n";
$headers = "From: sender@example.com\r\n";
$headers .= "Reply-To: sender@example.com\r\n";
$headers .= "CC: cc@example.com\r\n";
$headers .= "MIME-Version: 1.0\r\n";
$headers .= "Content-Type: text/plain; charset=ISO-8859-1\r\n";
if(mail($to, $subject, $message, $headers)){
echo "Email sent successfully!";
} else {
echo "Email could not be sent!";
}
}
?>
</body>
</html>