Detailed Request For Proposals are on file at the Division of Procurement, City Hall, 1st floor, between the hours of am pm. This application can be used to apply for Medicaid, the.Family Planning Benefit Program, or for assistance paying your health insurance premiums. Here's a cheatsheet, a foolproof stepbystep guide on how to fill health insurance claim form so you can never go wrong! Request for Proposals for Insurance Broker Services the Township of West Orange is requesting. If you recieve Medicaid through your local department of social service (LDSS), you may fill out form DOH-5247 and submit this with your renewal. Bidders must complete and submit a signed original of each and the applicable number of copies of each with each Bid. 15.