I choose to keep my spouse as my primary PRSB beneficiary but wish to add a contingent beneficiary

As a married NYSNA Pension Plan participant, your spouse is automatically your designated beneficiary for the Preretirement Survivor Beneficiary benefit and you don't need to do anything further to ensure your spouse receives this benefit in the event you die prior to your retirement. 

However, you are eligible to designate a non-spouse contingent beneficiary to receive your preretirement survivor benefit if your spouse predeceases you prior to your retirement date. To name a contingent beneficiary you must fill out the Preretirement Survivor Benefit Beneficiary Designation Form For Married Participants. 

The Plan offers several options below for the submission of your contingent beneficiary information. You may download the form, complete it manually, and then either e-mail, fax, mail, or securely upload the form to the Plan office.

Before you begin, please make sure you have the following information on hand. You won’t be able to submit your form without it:

  • Social Security number for each beneficiary you will be designating;
  • Address for each beneficiary;
  • Date of birth for each beneficiary.

Please choose a submission option below to designate your non-spouse contingent beneficiary:

Online Form Completion and Submission

This is the easiest way to complete and submit your form to the Plan. The Pension Plan uses DocuSign to provide secure submission of your beneficiary information. Part of this process requires a verification procedure (Knowledge-based Authentication or KBA) to confidentially verify your identity. We don't retain any of your personal information during this process.

  1. To begin, click the button below. 
  2. You must enter some simple personal information for KBA purposes, including your name, address and for best results, your date of birth or social security number.
  3. Click "Next."
  4. Answer the series of identification-related questions, which will verify your identity.
  5. If your identity is successfully verified, you will be directed to the document for completion. In addition, an email will be sent to you for the option to complete the document later, however, doing it immediately is always the best option.
  6. Click “Continue.”
  7. Review the “Electronic Record and Signature Disclosure” and check the checkbox indicating your agreement to receive and sign the document electronically.
  8. Click "Continue."
  9. Click the “Start” tag when you are ready to fill out the form.
  10. Click the "Continue" button to fill in all the required question fields. There are required and optional fields. Please complete as many optional fields as possible.
  11. You will need to “Adopt a Signature” by typing or drawing your signature. Click “Adopt Signature” to accept the signature and then click “Apply Signature” to add it to your form.
  12. Click the “Finish” button to submit your form to the Plan. You will be given the option to download the form for your records and an email with the completed documents will be sent to you.

Paper Form Completion and Submission

Begin by downloading, printing, and completing the form.

Download Form

Once you've completed the form and signed it, use one of the methods below to submit the completed form.

Mobile Upload

This is the easiest way to provide your signed paperwork to the Plan. Use the button below to access our secure upload site. Use the "Browse files" link to use your camera to take a photo and upload it in one step.


Submit via email

Simply sign your paperwork, take a picture, and email it to prsbforms@rnbenefits.org using the link below.


Submit via fax

Fax your signed paperwork to (518) 456-3954.