The Empire Plan is a unique health insurance plan designed especially for public employees in New York State. Empire Plan benefits include inpatient and outpatient hospital coverage, medical/surgical coverage, Centers of Excellence for transplants, infertility and cancer, home care services, equipment and supplies, mental health and substance abuse coverage and prescription drug coverage.
KATHY HOCHUL
Governor
TIMOTHY R. HOGUES
Commissioner
NY24-10
PE24-06
TO: Health Benefits Administrators of New York State Agencies and Participating Employers
FROM: Employee Benefits Division
SUBJECT: Donate Life Registry Election Added to NYSHIP Health Insurance Transaction Form (PS-404)
DATE: June 20, 2024
As per New York State Public Health Law 4310, the Department of Health has established an organ, eye, and tissue donor registry (called the “donate life registry”) which provides a means to make and register a gift of organs, eyes and tissues to take place after death. The donate life registry contains a listing of all donors who have declared their consent to make an anatomical gift.
Chapter 758 of the Laws of 2022 amends Public Health Law 4310 to extend the option for an insured and/or applicant for insurance to indicate they would like to be added to the Donate Life Registry and consent to organ, eye and tissue donation during enrollments.
Accordingly, the Employee Benefits Division (EBD) has added a Donate Life Registry Election section to form PS-404, NYSHIP Health Insurance Transaction Form for NYS & PE Employees. Enrollees must fill out this section by checking either the “Yes” or “Skip this question” box. The election must be made each time a new form is submitted.
Effective immediately, please discontinue use of all prior PS-404 forms. The new version of the form is attached to this memo and posted to the Publications & Forms section of HBA Online.
Processing the Donate Life Registry election in NYBEAS
If the enrollee selects “Yes” to be added to the Donate Life Registry, the election must be processed in NYBEAS. If the enrollee selects “Skip this question,” no further action is required. To process the election, go to Benefits/Transactions/Donate Life Registry Elect.
Add the enrollee’s EmplID number.
Check the “This employee has elected to be added to the Donate Life Registry” box. If available, add the enrollee’s 9-digit NYS Driver License/Learner Permit ID Card number. Please note that a NYS Driver License/Learner Permit ID Card is not required to elect to be added to the Donate Life Registry.
Select Save and the election will be entered successfully.
If enrollees wish to remove themselves from the registry, please direct them to contact the Donate Life Registry at 1-866-NY-DONOR or registry@donatelife.ny.gov for further assistance.
If you have questions about this memo, please contact the HBA Helpline at 518-474-2780.