Cancel an Enrolled Employee's UPC Membership

We’re hard at work adding this functionality into our Portal directly so that you see your changes in real time! In the meantime, rest assured that our team will receive and execute all form submissions within a business day.

Cancel an Enrolled Employee’s UPC Membership

Employer Name(Required)

Your Name

First Last

Employee Name(Required)

First Last

Employee Email(Required)

Effective Date(Required)

Effective date defaults to the last day of the current month. For example, if you are submitting a cancellation between January 1 – January 31, the cancellation will be effective January 31. Cancelations cannot be submitted retroactively. If you have any questions, please contact your dedicated account manager.

Cancelation Reason(Required)