Human Resources • DIOCESE OF BRIDGEPORT

COVID-19 Information:

• Vaccination Flyer (PDF)

Updates:

• Benefit Resource Center flyer — NEW

Overall Summary:

• 2022 Benefits Booklet (PDF)
• 2022 Benefits Rate Sheet (PDF)
• 2022 Employee Benefit Overview (PDF)

AETNA Benefit Plans:

• 2022 Aetna Medical Benefit Summary (PDF)
• 2022 Aetna Vision Summary (PDF)
• Aetna Cost Estimator Information

Delta Dental Benefit Plans:

• 2022 Delta Dental Benefit Summary (PDF)

Other Valuable Benefits:

• Supplemental Insurance —
  SunLife Generic Booklet 2022 Cemeteries Employees (PDF)
  SunLife Generic Booklet 2022 All Employees (not Cemeteries) (PDF)
• Flexible Spending Account
• Mutual of America Financial Group Plan Information:
  Participant Account Representative401(a) Summary Plan Description
  401(a) Enrollment Form
  401(a) Initial Summary ProspectusTDA (3b) Summary Plan Description
  TDA (3b) Enrollment Form
  TDA (3b) Initial Summary Prospectus
  TDA (3b) Payroll Deferral Election Form

Discount Programs:

• Travelers Auto and Home Discounts Available!
• Verizon – Employee Discount (Non Profit Organizations)

Self-Service Benefit Contact Information:

• Diocesan Dedicated Benefit Call Center  |  1-855-874-6699 (8am to 5pm 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