Overall Risk Level
error High Risk
Risk Flags
flagActive federal class-action lawsuit (SDNY) alleging 'ghost network' deceptive provider directory practices affecting 1M+ NYSHIP/Empire Plan members; court denied motion to dismiss, allowing key claims to proceed (2026)
flagThird class action filed in under a year against Carelon/Elevance/Anthem over provider network adequacy
flagBBB complaint themes: claims processing delays, coverage denials, unresponsive customer service, billing errors
flagNot BBB accredited despite A+ rating
flagCalifornia DMHC enforcement action listing exists for Carelon Behavioral Health of California
Legal Issues
gavelPollock Cohen LLP / Walden Macht Haran & Williams class action (filed April 2025, SDNY) alleging false advertising and deceptive network adequacy claims; court allowed key claims to proceed in April 2026
Ethical Concerns
policyAllegations of publishing inaccurate/inflated provider directories ('ghost networks') to lure members into plans
BBB RatingA+
Employee Sentiment
5.6
out of 10
Management