AETNA Benefit Plans:
- 2017-2018 Aetna Medical Benefit Summary (PDF)
- 2017-2018 Aetna Dental Benefit Summary (PDF)
- 2017-2018 Aetna Vision Summary (PDF)
- 2018 Benefits Booklet (PDF)
- 2018 Employee Rates (PDF)
- 2018 New Hire -How to search for a Medical or Dental Provider by tier
- Aetna Cost Estimator Information
Rx Benefit Plan:
- 2018 How the Diocese Rx Plan Works
- 2018 Rx Premier Plus Formulary Listing
- 2018 Healthy Actions – Rx Savings Drug Class $0 co-pay
Other Valuable Benefits:
- Supplemental Insurance — Colonial Life Voluntary Benefit Brochure 2017- 2018 (PDF)
- Flexible Spending Account
- Mutual of America – Retirement Plan Information:
401(a) Summary Plan Description (SPD)
403(b) Summary Plan Description (SPD)
403(b) Payroll Election Form-revised as of 7.25.2017
403(b) TDA Enrollment
401(a) Election form – Rev. 2016
St. Vincent’s Health Partners:
Discount Programs:
Self-Service Benefit Contact Information:
- Diocesan Dedicated Benefit Call Center | 844-675-8539 (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
- Aetna Dental Member Service | 1-877-238-6200 | www.aetna.com
- Aetna Vision | 1-877-973-3238 | www.aetnavision.com
- P&A Group Account Flex Spending | 1-800-688-2611 | www.padmin.com
- Colonial Life Supplemental Insurance | 800-325-4368 | www.coloniallife.com
- Paychex Flex (Online Benefit Website) | www.mypaychex.com
- 24/7 telephone access to US board–certified doctors | (855) 835-2362 | www.teladoc.com
Employment/Tax Documents
Employment Application (PDF)
2016 CT-W4 (PDF)
2016 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
