Form 5500 · Employee benefit plan · CINCINNATI, OH
GRAPHIC VILLAGE LLC
The filing calls this plan GRAPHIC VILLAGE LLC WELFARE BENEFITS PLAN.
Public Form 5500 records show how GRAPHIC VILLAGE LLC of CINCINNATI, OH, a manufacturing employer, structures its employee benefits. Its broker of record is SECOND ACT BENEFITS INC. Coverage is written through SUPERIOR DENTAL CARE and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 46-1560163 · plan 501 · plan year 2024, filed Jul 3, 2025
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
2 contracts on this filing do not say which benefits they cover, so a line above may be insured by one of them.
Also declared: other welfare, death benefits.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 8 insured contracts covering dental, vision, life and disability; the largest, with SUPERIOR DENTAL CARE, covers 123 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, placed with a carrier that is not on this filing, or written on one of the 2 contracts here that do not say what they cover.
Reported premium is $190,533; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
SECOND ACT BENEFITS INC is the broker of record on 1 of the 8 contracts; the rest name a different broker or none.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| SUPERIOR DENTAL CARE | Dental | 123 | Jan 1, 2025 | $48,936 | $0 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 178 | Jan 1, 2025 | $47,919 | $0 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 69 | Jan 1, 2025 | $29,635 | $0 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Disability | 178 | Jan 1, 2025 | $26,447 | $0 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 43 | Jan 1, 2025 | $14,303 | $0 |
| FIDELITY SECURITY LIFE INSURANCE COMPANY | Vision | 192 | Jan 1, 2025 | $10,728 | $0 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | Life | 178 | Jan 1, 2025 | $7,090 | $0 |
| UNITED OF OMAHA LIFE INSURANCE COMPANY | — | 39 | Jan 1, 2025 | $5,475 | $0 |
Premium and claims on this contract
SUPERIOR DENTAL CARE, contract 0137950-01. For the contract year on this filing, the carrier reported $48,936 in premium earned and $48,279 in claims incurred. Dividing one by the other gives 99%.
- SUPERIOR DENTAL CARE, contract 0137950-01 reported $31,876 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 175 employees, 1 recordable cases, 2 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
How this plan compares
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