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HOW TO GET STATED? JUST FOLLOW THE SIMPLE INSTRUCTIONS BELOW. ACCIDENT PROGRAMS ACCIDENTAL DEATH & DISMEMBERMENT MEDICAL/DENTAL EXPENSE PLAN SHORT/LONG TERM DISABILITY INCOME |
1. Complete Accident Enrollment Form 2. Complete Billing Authorization Form 3. Please enclose premium check with $40 one-time Lifetime Association Fee made out to CDBA (Consumer Driven Benefits Association). All applications with premium check including association fee must be in this office 25th of the month for an effective date of the 1st of the following month. |
PLEASE MAIL TO: CAPOL SERVICES, INC. ATTN: TERENCE BEADLE 2655 DALLAS HIGHWAY, SUITE 610 MARIETTA, GA 30064 Phone 770-792-6301 -- Fax 770-420-6437 |