Forms
Please open the application below. Print the form pages and complete, then mail to:
The Capitol Group
4128 A Innslake Drive
Glen Allen, VA 23060
You may also fax the pages to (804) 741-9226
Employee Health Enrollment Application Group Size 2-14
Employee Health Enrollment Application Group Size 15+
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The Capitol Group
4128 A Innslake Drive
Glen Allen, VA 23060
Toll Free: (800) 527-0669 - Local: (804) 741-4444 - Fax: (804) 741-9226
Copyright 2008-2019. The Capitol Group of Companies. All rights reserved.
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The Capitol Group of Companies
P.O. Box 70070 Richmond, Virginia 23255
Toll Free: (800) 527-0669 - Local: (804) 741-4444 - Fax: (804) 741-9226