You can apply online for AHCCCS Medical Assistance, Nutrition Assistance, and Cash Assistance using Health-e-Arizona Plus (HEAplus). Please go to the Arizona Procurement Portal (APP) for information and to submit proposals.Arizona submitted a Title XXI State Plan to extend health care coverage statewide for children up to the age of 19. The effective date for the State Plan. You'll get notices (letters, emails, or both) telling you which documents to submit. You may get a notice from your health insurance company too. This document outlines the Common Proposal Form for health insurance applications, designed to gather essential details from applicants. Notification of Health Insurance Coverage. Form Number 05-5542. How to fill out the Proposal Form for Package Products and Health Insurance?