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Form 5500 · Employee benefit plan · HOUSTON, TX

ELYSIAN LIVING, LLC

The filing calls this plan ELYSIAN LIVING LLC HEALTH AND WELFARE BENEFIT PLAN.

ELYSIAN LIVING, LLC of HOUSTON, TX insures health, dental, vision, life and disability coverage for its employees, per Schedule A of its Form 5500. Its broker of record is BROWN AND NOYES, LLC. Coverage is written through CIGNA HEALTH AND LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in June.

Benefits broker of record
Policy year ends
Juneas filed for plan year 2025

Sourced from U.S. DOL EFAST2 Form 5500 · EIN 47-5573352 · plan 501 · plan year 2025, filed Dec 5, 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.

All participants at the start of the year
180
Active at start of year
180
Active at end of year
158
Disclosed commissions
$14,460
Typical renewal
July 1

Benefits declared on this filing

Healthinsured — CIGNA HEALTH AND LIFE INSURANCE COMPANY110 of 180 participants (61%) on the largest contract
Dentalinsured — CIGNA HEALTH AND LIFE INSURANCE COMPANY110 of 180 participants (61%)
Visioninsured — CIGNA HEALTH AND LIFE INSURANCE COMPANY110 of 180 participants (61%)
Lifeinsured — THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA155 of 180 participants (86%)
Disabilityinsured — THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA155 of 180 participants (86%)

Also declared: death benefits, other welfare.

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 2 insured contracts covering health, dental, vision, life and disability; the largest, with CIGNA HEALTH AND LIFE INSURANCE COMPANY, covers 110 people.

Reported premium across the insured contracts is $100,939, with $14,460 in disclosed broker commissions — about 14% of premium.

The most recent policy period ended in June, and the plan year ends June 30. Group contracts typically renew on that annual cycle.

BROWN AND NOYES, LLC is the broker of record on all 2 contracts.

Two carriers split the book: CIGNA HEALTH AND LIFE INSURANCE COMPANY and THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA.

Schedule A insurance contracts

CarrierBenefitsCoveredRenewsPremiumCommission
THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICAHealth, Life, Disability155Jul 1, 2025$37,748$8,219
CIGNA HEALTH AND LIFE INSURANCE COMPANYHealth, Dental, Vision110Jul 1, 2025$63,191$6,241

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.

See the filing at the Department of Labor

Administrator and service providers

Plan administrator on the filing
ELYSIAN LIVING, LLC
EIN 47-5573352

The plan administrator is from line 3a of the main form. We publish company names only.

Other plans filed by this employer

How this plan compares

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