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
NY25-12
PE25-09
TO: Health Benefits Administrators of New York State Agencies and Participating Employers
FROM: Employee Benefits Division
SUBJECT: Notification Preferences Added to NYSHIP Health Insurance Transaction Form for NY/PE (PS-404)
DATE: June 17, 2025
The Employee Benefits Division (EBD) has added a Notification Preferences section to the PS-404 form, NYSHIP Health Insurance Transaction Form for NYS & PE Employees. This new section allows enrollees to change how they receive NYSHIP publications.
Enrollees may choose one of the following options:
- "I would like to receive publications by email only"
- "I would like to receive publications by email and mail"
If an enrollee does not select an option, they continue to receive publications by mail only.
Effective immediately, please discontinue use of all prior versions of the PS-404 form. The updated version is attached to this memo and is also posted in the Publications & Forms section of HBA Online.
A new supplement to the PS-404 form is also available: PS-404S, NYSHIP Health Insurance Transaction Form Additional Dependent Information Supplement. It allows enrollees to add or update more dependents than the PS-404 form can accommodate. This supplement is attached to this memo and is also posted in the Publications & Forms section of HBA Online.
Processing the Digital Correspondence election in NYBEAS
Enrollees may choose one of the following options:
- "I would like to receive publications by email only"
- opts into receiving digital NYSHIP publications by email, and
- opts out of receiving printed NYSHIP publications by mail
- "I would like to receive publications by email and mail"
- opts into receiving digital NYSHIP publications by email
If the enrollee checks one of these boxes, enter their election in NYBEAS.
To enter the election in NYBEAS: Go to Benefits > Transactions > Digital Correspondence Elect.
Enter the enrollee's Employee ID or their first and last name.
Before selecting the election, make sure:
- An Email Type is selected
- The Email Address is filled in and is their personal email address (double-check the spelling)
- The "Preferred" box is checked
Check the box labeled "This employee has elected to receive digital publications." If the enrollee also wants to stop receiving printed copies, check the second box. After checking the first box, a reminder message to check the second box will pop up. By only checking the first box, the enrollee will receive both email and printed publications.
An enrollee cannot be opted out of print without also being opted into digital publications.
Select Save and the election will be entered successfully.
If an enrollee states that they didn't receive a publication in the mail, verify whether they opted out of printed publications. Go to the Personal / Employment page and open the Address / Phone tab.
Below the email address section, look for the line: “To opt into/review digital communications, click here.” Click the “click here” link to open the Digital Correspondence Elect screen. The screen displays whether the enrollee has elected to stop receiving print publications. The enrollee’s option can also be changed on that screen.
If you have questions about the NYSHIP email project, please email communications@cs.ny.gov. If you have questions about this memo, please call the HBA Helpline at 518-474-2780.