COVID-19 Information:
Other Valuable Benefits:
- 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:
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
