Application Process

To apply for New York statutory disability benefits insurance with NYSIF, an employer must submit a disability benefits application and include a $60.00 check for the initial premium deposit. A disability benefits insurance application form UDB-36 may be downloaded directly from this web site or requested by calling our disability benefits Customer Service Department toll free at:

1-866-NYSIF-DB (1-866-697-4332)

Once you complete all sections of the application, submit it with a minimum premium deposit check for $60.00 made payable to NYSIF Disability Benefits. Mail the completed application and deposit check to:

NYSIF Disability Benefits
15 Computer Drive West
Albany, NY 12205

If the application is complete and approved, coverage begins on the day following the postmark on the mailed envelope, unless you request a future date of coverage.

The policy period remains in effect for one year from inception date. At the end of the policy period, the policy automatically renews unless the policyholder notifies NYSIF to cancel the policy. To cancel a policy, New York State Law requires policyholders to provide 30 days written notice to NYSIF.

If an applicant has a previous disability benefits or workers’ compensation insurance policy with NYSIF with an outstanding balance, the previous account must be finalized and any outstanding balance paid before a new policy may be issued (Section 93B, NYS Workers’ Compensation Law).

NYSIF’s minimum disability benefits premium is $60.00 per year.

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