Additional insurance information is available at Student Health Services. This application can be used to apply for Medicaid, the.Family Planning Benefit Program, or for assistance paying your health insurance premiums. These sample letters can be used in various circumstances you may encounter that require you to communicate with insurance companies. Take a few seconds and answer the following questionnaire! These questions will help guide you in determining your eligibility for MVAIC benefits. Go to the College Human Resources Office, Tower 7, and fill out a Nassau County. Health Insurance Transaction Form. Copy of current New York State Registration (signed). â–¡. Complete a Late Waiver Appeal Form.