Benefits Fund Enrollment Form - the NYSNA Pension Plan and - rnbenefits 2025

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin by filling in your personal information. Clearly print your last name, first name, and middle initial. Provide your street address, apartment number (if applicable), birth date, city, state, and ZIP code.
  3. Next, enter your contact details including home phone, cell phone, and email address. Indicate your gender and provide your employer's name along with your employment date and position title.
  4. For dependents, fill in the required information for your spouse and children. Include their names, birth dates, social security numbers, and health insurance details where applicable.
  5. Designate life insurance beneficiaries by providing their full names, addresses, social security numbers, and relationships to you. If you have more than two beneficiaries, prepare a notarized letter as instructed.
  6. Finally, review all entries for accuracy before signing the form. Ensure it is dated correctly before submission to the Fund office.

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A pension plan is a benefits program set up and sustained by an employer or an employee group. They are managed by state or private firms as well as pension funds. Pension funds are financial mechanisms that provide retirement income for employees after their working life.
Can I continue my NYSHIP coverage when I retire? You can continue your coverage as a New York State retiree if you meet all of the eligibility requirements.
You need five years of credited service to be vested in the NYSNA Pension Plan, and at least one of those years must be future service.
We are NYSNAthe New York State Nurses Association. With over 42,000 members, NYSNA gives frontline nurses and healthcare professionals a unified voice to promote the health and welfare of our members, our profession, and the people of New York state.
Is a nonprofit organization formed to provide NYSNA members and participating employers an affordable, comprehensive, and efficient plan of health insurance.
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Established in 1972 and located in Albany, NY, the New York State Nurses Association Pension Plan and Benefits Fund are separate, multiemployer plans providing health insurance and retirement benefits for RNs and other medical professionals throughout New York State represented under collective bargaining by NYSNA.

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