Can I use Permissions Wizards to add a new Unity Admin account. UnityAdmin works fine, but we want to add another account for administrator purposes. Does this work in 4.2, or are we stuck with UnityAdmin only?
Yes, it works the same in 4.x and 5.x. You either add a subscriber who is in the Class of Service (COS) with access to the SA, or you run GrantUnityAccess to associate an AD user account with UnityAdmin or Installer or some other account with access to the SA. The links Sonya provided has lots of detail.
Check out this link that discusses administrator accounts: http://www.cisco.com/en/US/docs/voice_ip_comm/unity/5x/administration/guide/ex/5xcusag020e.html
This section within that document above describes specifically how to create an account that you can use to administer Unity: http://www.cisco.com/en/US/docs/voice_ip_comm/unity/5x/administration/guide/ex/5xcusag020e.html#wp1047896
The short answer is that you do not use Permissions Wizard to set any permissions required of a Unity System Admin Account. As is shown in the Permissions Wizard help file, the only accounts for which PW sets rights are: unity install, unity directory service and unity message store: http://www.ciscounitytools.com/HelpFiles/PW501/PWHelp_ENU.htm#Exchange
I hope this helps.