Retiree, Medicare & Healthcare Forms
Click on the Links below to Download Form:
Active employees must change their address in Peoplesoft / Self Service
Click below for Retiree, Medicare & Healthcare Links:
Search for UHC In-Network Physician, Laboratory or Facility
Port Authority Website - Healthcare Forms Page - Website page temporarily unavailable
Click on Links below for NYS&LRS Forms
Healthcare Proxy - Living Will - DNR Forms
* Many States like New York State have created forms for the Public to use for a Healthcare Proxy & a Living Will so those who cannot afford a lawyer can create a form that is legal and should be filled in and posted in a prominent location in your home such as the o refrigerator. However, the DNR form comes with much controversy and I found that every State requires a different form so I will provide a form for DNR (Do Not resuscitate) only for the State's of NY and NJ.
My daughter is a Paramedic with the FDNY and told me that unless someone can provide a official State of NY DNR on the spot when EMS arrive to your home in NY on an emergency call they must perform everything they can to resuscitate you, even if you tell them you have an official DNR that is somewhere else but not here.
The NYS&LRS does not have a change of address form for retirees they give the following instructions on their website:
You can contact us regarding your address change by email, letter, fax or telephone. If you’re sending a letter or fax, be sure to include your name, old and new address, retirement or social security number, and signature in your correspondence. If you call us, we’ll ask you questions confirming your identity before we change your address in our records. If you email us, we will call you and ask you questions confirming your identity before we change your address in our records. Please realize that we must have a signed letter from you if your new address includes a PO Box or a location outside of the United States.
New York State and Local Retirement System
Pensioner Services -
6th Floor 110, State Street
Albany, NY 12244-0001
Phone Numbers: (Certain automated phone info available 24/7)
Long-distance within the 50 states, Puerto Rico and Virgin Islands, call toll-free: 1 (866) 805-0990
Locally within the Albany, New York area, call:
General Fax Number: (518) 402-4433
Please include your name, social security number and a phone number where we can
reach you as well as the name or department that you are trying to reach with your fax.
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