Cancel a Policy
To cancel a Disability Benefits policy, policyholders must complete NYSIF Form UDB-89 and return it to NYSIF at least 30 days before the intended cancellation date.
Please print the Form UDB-89 and complete it in full, being sure to provide the following:
- Policyholder’s name and current address
- Policy number
- Reason for cancellation or non-renewal
- Effective date of cancellation
- Policyholder signature
Return Form UDB-89 to NYSIF
You can fax Form UDB-89 to NYSIF at 518-437-5278, or mail the completed form to the address below:
PO Box 66699
Albany, NY 12206
After Cancellation – Final Payroll Report
Once your policy is canceled, on the next business day following the effective cancellation date, we will send you a letter requesting a final payroll report. Your account will then be adjusted accordingly, and a final statement will be issued.