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Office of the New York State Comptroller’s Seal

NYS Comptroller

Thomas P. DiNapoli

Retiree Annual Statement Guide

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Items in Your Statement

Retirement #
We use this to identify retirees as an alternative to your Social Security number to protect your privacy and ensure your information is secure.
Total Normal Benefit
The amount of your monthly payment before taxes and any deductions or credits.
Total COLA / Supplement Allowance
Credits to your monthly payment intended to help your pension keep pace with inflation. See our Cost-of-Living Adjustment page for more information.
Total Benefit Adjustments
Changes to your pension benefit that can include deductions for equitable distributions, workers’ compensation, tax liens, alimony and child support.
Total Medicare Credits
If you retired from a New York State agency and are enrolled in a plan under the New York State Health Insurance Program (NYSHIP), this is the annual credit you receive reimbursing you for Medicare Part B. If you receive reimbursement from another source, your statement will show $0.00.
Contact your benefit provider with any questions.
Total Miscellaneous Deductions
Usually dues or fees you’ve agreed to pay through pension deductions. For example, union dues would appear here.
Total Federal Withholding Tax
Money held back for federal income tax. You may change this amount by sending a revised W-4P form Adobe pdf to:

NYSLRS

Attn.: Tax Unit, 4th floor

110 State Street

Albany, NY 12244-0001

Total Health Insurance Premiums
NYSLRS does not administer health insurance benefits. However, we can deduct retiree premiums from pension payments at your former employer’s request. If you have questions about health insurance coverage and you retired from a New York State Agency, contact the New York State Department of Civil Service. If you retired from a public employer other than New York State (a county, city, town, village or school district), please contact your former employer’s benefits administrator.
If you pay out-of-pocket, your statement will show $0.00.
Total Net Benefit
Your total pension payout for the year, after all taxes, deductions and credits.

Tax Filing

Do not use this statement for tax purposes. If your pension is taxable, we send you a 1099-R form separately. If you haven’t received one, we may not have your correct mailing address on file. If you’ve recently moved, contact us to share your new address with NYSLRS. Please note: we don’t issue a 1099-R form if you are receiving a disability retirement benefit that isn’t taxable.

Your Benefit Payment Option

Your benefit payment option is the way you chose to receive your pension benefit at retirement.

Note: If you chose a “pop-up” option and your beneficiary has died, your statement will still reflect that option. Only the amount of your benefit changes, not the option itself.

For more information about options, visit our Payment Option Descriptions page.

(Rev. 2/17)

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