._separator_eiwbt_1{background-color:var(--border-default);width:100%;height:1px;margin:24px 0}._addCoverage_eiwbt_8{margin-left:-10px}._date_eiwbt_12{display:flex;flex-direction:column}._date_eiwbt_12 h2{color:var(--element-default);font-size:14px}._dateWrapper_eiwbt_21{display:grid;grid-gap:0 16px;grid-template-columns:1fr 1.5fr 1fr}._formWrapper_eiwbt_27{display:grid;min-height:50%;grid-auto-flow:column;grid-gap:24px 64px;grid-template-columns:1fr 1fr;grid-template-rows:55px 16px repeat(4,55px) 16px;max-width:80%}._coverageWrapper_eiwbt_37{height:100%;margin-top:8px;font-style:normal;font-weight:500;font-size:14px;line-height:18px;color:var(--element-default);grid-column:2}._coverageList_eiwbt_48{overflow-y:auto}._footer_eiwbt_52{position:fixed;right:40px;bottom:40px;display:flex;align-items:flex-end;justify-content:flex-end;gap:24px;margin-top:auto}._totalAdded_eiwbt_63{color:var(--element-default);text-align:right;font-size:16px;font-style:normal;font-weight:400;line-height:normal}._view_eiwbt_72{grid-column:2}
