Medical, Dental, Vision Benefits:
All information is provided on the www.retatrust.org site, which requires you to log into your account to view.
Other Valuable Benefits:
- Mutual of America Financial Group Plan Information:
Participant Account Representative
401(a) Summary Plan Description
401(a) Enrollment Form
401(a) Initial Summary Prospectus
TDA (3b) Summary Plan Description
TDA (3b) Enrollment Form
TDA (3b) Initial Summary Prospectus
TDA (3b) Payroll Deferral Election Form
Information about your SPD
Discount Programs:
Important Benefit and Retirement Contact Information:
- RetaTrust Client Services Center | 877-303-7382 | www.retatrust.org | email service@RetaEnroll.org (8:30 am to 8:00 pm Eastern time)
- Medical | Reta Blue Shield Plan | 888-772-1076 | www.blueshield.com
- Pharmacy | Reta CVS Plan | 800-844-0719 | www.caremark.com
- Dental | Delta Dental of California | 800-765-6003 | www.deltadentalins.com
- Flexible Spending Accounts Benefit Allocation Service (BAS): 800-945-5513 www.basusa.com
- Employee Assistance Program (EAP) | Wheeler | 888-793-3500 | www.wheelerclinic.org
Confidential and available 24 hours a day, seven days a week - Retirement 401(a) and 403(b) | Mutual of America | 1-866-954-4321 | www.mutualofamerica.com | Lana Robinson, Participant Account Representative | 860-430-7044 | Lana.Robinson@mutualofamerica.com
Employment/Tax Documents:
Employment Application (PDF)
2024 CT-W4 (PDF)
2024 W-4 (PDF)
Direct Deposit (PDF)
2024 I-9 (PDF)
Computer Usage Guidelines (PDF)
Emergency Contact Info (DOC)
Virtus Online Registration (PDF)
Procurement of an Investigative Report Authorization (DOC)
Executive Summary for Lay Employees (PDF)
Background Checks
The following forms are to be used for volunteers and those who are contracted to do work for Diocese of Bridgeport. Please contact the Human Resources Department with any questions.
MYB Employee Authorization Form (PDF)
MYB Volunteer Authorization Form (PDF)
Consumer Rights on background checks under the Fair Credit Reporting Act (PDF)
More information on MYB
More information on Safe Environments
