New York Class Action Lawsuit Claims ‘Ghost Network’ Limits Empire Plan Member Access Through Carelon Behavioral Health

On April 28, 2025, a class action lawsuit was filed in New York against Carelon Behavioral Health (Carelon), which provides mental health benefits to state and municipal employees who choose the Empire Plan under the New York State Health Insurance Program (NYSHIP). Their key complaint is that Carelon’s provider organization directory included listings as “in-network” for clinical behavioral health professionals and provider organizations who did not accept the Empire Plan insurance. The plaintiffs characterized the directory as a misleading “ghost network.”

NYSHIP offers state employees health insurance coverage through health maintenance organization options and the Empire Plan. The . . .