Overall Summary:
Open Enrollment:
AETNA Benefit Plans:
- 2021 Aetna Medical Benefit Summary (PDF)
- 2021 Aetna Vision Summary (PDF)
- Aetna Cost Estimator Information
Delta Dental Benefit Plans:
Other Valuable Benefits:
- Supplemental Insurance —
SunLife Generic Booklet 2020 Cemeteries Employees (PDF)
SunLife Generic Booklet 2020 All Employees (not Cemeteries) (PDF) - Flexible Spending Account
- Mutual of America – Retirement Plan Information:
401(a) Summary Plan Description (SPD)
403(b) Summary Plan Description (SPD)
403b Enrollment Form
403(b) Payroll Election Form-revised as of 7.25.2017
St. Vincent’s Health Partners:
Discount Programs:
Self-Service Benefit Contact Information:
- Diocesan Dedicated Benefit Call Center | 1-855-874-6699 (8am to 8pm EST)
- AETNA Members Services and Wellness | 1-800-962-6842 | www.aetna.com
- RX Member Services | 1-888-792-3862 | www.aetna.com
- Delta Dental Member Service | 1-800-452-9310 | www.deltadental.com
- Aetna Vision | 1-877-973-3238 | www.aetnavision.com
- P&A Group Account Flex Spending | 1-800-688-2611 | www.padmin.com
- Mutual of America | 1-866-954-4321 | www.mutualofamerica.com
- 24/7 telephone access to US board–certified doctors | 1-855-835-2362 | www.teladoc.com
Employment/Tax Documents:
Employment Application (PDF)
2021 CT-W4 (PDF)
2021 W-4 (PDF)
Direct Deposit (PDF)
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 by emailing HRdept@diobpt.org.
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
