
Carelon is owned by Elevance Health, Inc. (NYSE: ELV), a publicly traded health insurance company headquartered in Indianapolis, Indiana. Carelon operates as Elevance's health services subsidiary, administering behavioral health benefits, medical benefit management, and payment integrity programs. The division serves over 1 million patients through New York's Empire Plan alone. In March 2026, a federal judge allowed a class action lawsuit alleging Carelon maintained ghost provider networks to proceed.
Parent Company
Founded
2022
Status
Publicly Traded
Headquarters
| Brand | Parent Company | Ownership Type |
|---|---|---|
| Carelon | Elevance Health Inc. | Subsidiary |
Carelon's origins trace back to several acquisitions and business lines that Elevance Health (then Anthem) assembled over more than a decade. The division's largest component, Carelon Behavioral Health, descends from Beacon Health Options, a behavioral health management company that Anthem acquired in 2020.
Beacon Health Options was itself the product of a 2014 merger between Beacon Health Strategies and ValueOptions, two behavioral health management organizations. Before Anthem's acquisition, Beacon served over 40 million members across 50 states and managed behavioral health benefits for state Medicaid programs, federal employees, and commercial health plans.
Anthem acquired Beacon Health Options in 2020 to strengthen its behavioral health capabilities. The acquisition brought expertise in managing mental health and substance use disorder benefits, an area of growing demand. At the time, Anthem was already one of the largest Blue Cross Blue Shield operators, and adding Beacon's behavioral health infrastructure allowed the company to offer more integrated care management.
In June 2022, Anthem rebranded as Elevance Health and announced the creation of Carelon as its health services brand. The Carelon brand unified several existing business lines under a single identity. Carelon Behavioral Health replaced the Beacon Health Options name. Carelon Medical Benefits Management consolidated Anthem's radiology, cardiology, and specialty drug management services. Carelon Payment Integrity brought together claims payment and fraud detection operations.
The rebranding reflected a strategic shift at Elevance Health. The company wanted to position itself as more than an insurance provider. By creating Carelon as a distinct brand, Elevance Health signaled its intention to grow its health services business both internally and externally. Carelon could sell its services to other health plans and employers, not just to Elevance Health's own insurance operations.
Carelon Behavioral Health administers mental health and substance use disorder benefits for health plans and employers. The company contracts with states to manage behavioral health benefits for public employees. Its largest single contract is with the New York State Health Insurance Program (NYSHIP), where it administers mental health benefits for the Empire Plan. This contract is valued at more than $2.7 billion and runs through the end of 2028.
Carelon Medical Benefits Management provides prior authorization and clinical review services for high-cost medical procedures. This includes radiology management (ensuring appropriate use of imaging services), cardiology management, and specialty drug management. These services help health plans control costs by reviewing whether requested procedures are medically necessary.
Carelon Payment Integrity focuses on detecting and preventing improper payments in healthcare claims. The division uses data analytics to identify billing errors, duplicate claims, and potential fraud. This service is offered to both Elevance Health's insurance plans and to external clients.
What does Elevance Health own?
Elevance Health owns Anthem Blue Cross Blue Shield health insurance plans operating in 14 states, the Wellpoint subsidiary brand, and the Carelon health services brand including CarelonRx (pharmacy benefits management) and Carelon Services (behavioural health, care management, and risk-based solutions). The company also offers dental insurance through Anthem Dental Plans and Blue Cross Blue Shield Dental. Elevance was formerly known as Anthem until rebranding in June 2022.
Is Elevance Health publicly traded?
Yes. Elevance Health is listed on the New York Stock Exchange under the ticker symbol ELV. The company has been publicly traded since 2004, when it IPO'd under the name Anthem with ticker ANTM. The ticker changed to ELV in June 2022 when the company rebranded to Elevance Health. Major institutional shareholders include Vanguard Group, BlackRock, and State Street Corporation. The company returned $4.1 billion of capital to shareholders in 2025.
Who founded Elevance Health?
Elevance Health was formed through decades of mergers among Blue Cross and Blue Shield organisations, beginning in 1946. The current corporate structure resulted from the 2004 merger of Anthem and WellPoint Health Networks, which brought multiple state Blue Cross Blue Shield plans under a single entity. The company adopted the Anthem name in 2004 and rebranded to Elevance Health in June 2022 under CEO Gail Boudreaux's leadership.
Where is Elevance Health headquartered?
Elevance Health is headquartered in Indianapolis, Indiana, USA. The company operates Blue Cross Blue Shield plans in 14 states and serves approximately 45 million medical members across the United States. The company employs approximately 100,000 people. Carelon, the company's health services subsidiary, operates pharmacy benefits management, behavioural health, and care management services.
What is Elevance Health's annual revenue?
Elevance reported $197.6 billion in operating revenue for FY2025, a 12.8% increase from $175.2 billion in FY2024. Premium revenue was $164.6 billion, product revenue was $24.5 billion, and service fees were $8.5 billion. Shareholders' net income was $5.66 billion, with GAAP diluted EPS of $25.21. For FY2026, the company projects total operating revenue to decline in the low single digits, with GAAP diluted EPS of at least $22.30 and adjusted diluted EPS of at least $25.50.
Why is Elevance Health exiting Medicaid markets?
Elevance is exiting Medicaid markets where it cannot achieve sustainable margins due to elevated medical cost trends and state rate updates that have not kept pace with the higher acuity of remaining members after pandemic-era redetermination. The company exited the Washington, D.C. Medicaid market in August 2025 and expects to exit additional markets over 12 to 18 months. Medicaid is expected to operate at a -1.75% operating margin in 2026. CEO Gail Boudreaux stated that "Medicaid participation has to make strategic and financial sense for us within our diversified portfolio."
What is the DOJ lawsuit against Elevance Health about?
In May 2025, the US Department of Justice filed a False Claims Act complaint against Elevance Health, CVS Health (Aetna), and Humana, alleging the insurers paid hundreds of millions of dollars in illegal kickbacks to insurance brokers eHealth, GoHealth, and SelectQuote from 2016 through at least 2021 in exchange for Medicare Advantage enrolments. The DOJ alleges brokers directed beneficiaries to plans that paid the most in kickbacks regardless of suitability. The case is ongoing, and the claims are allegations only with no determination of liability.
Carelon does not hold independently verified sustainability certifications from recognized third-party organizations. The standard certifications tracked in consumer goods, such as cruelty-free, vegan, or B Corp, do not apply to a B2B healthcare services business.
Elevance Health publishes corporate responsibility reports covering environmental, social, and governance practices. The company has set goals for reducing its carbon footprint and improving health equity. These corporate-level commitments apply to Carelon as a subsidiary.
In terms of social impact, Carelon's behavioral health administration services affect millions of patients. The quality of these services, including the accuracy of provider directories and the timeliness of prior authorization decisions, directly affects patient access to mental health care. The ghost network lawsuit alleges that Carelon's practices have harmed patients by making it difficult to find in-network mental health providers.
Carelon as a brand has not been the subject of major independent industry awards as of August 2026. The division was created in 2022 and is still establishing its independent brand identity separate from Elevance Health.
Elevance Health has received recognition for its corporate practices, including inclusion in the Dow Jones Sustainability Index and recognition from the Human Rights Campaign for LGBTQ+ workplace equality. These recognitions apply to the parent company rather than to Carelon specifically.
Carelon Behavioral Health is the defendant in a class action lawsuit alleging the company maintained ghost provider networks for mental health services. The lawsuit, filed in April 2025 in the Southern District of New York (case 25-cv-03489), accuses Carelon of publishing inaccurate provider directories for the Empire Plan in the New York State Health Insurance Program.
Three plaintiffs filed the suit on behalf of more than 1 million Carelon patients enrolled in the Empire Plan. The plaintiffs allege that Carelon's provider directory listed mental health providers who were not actually in-network, not accepting new patients, or could not be reached at listed contact information. A secret shopper survey conducted by the plaintiffs' attorneys called 300 providers listed in Carelon's directory. Only 17% of those providers accepted the coverage and were taking new patients.
On March 31, 2026, Judge Edgardo Ramos denied Carelon's motion to dismiss the case. The judge dismissed breach of contract claims, finding that Carelon's contract was with New York State rather than with individual members. However, the judge allowed claims for deceptive business practices, deceptive advertising, fraudulent and negligent misrepresentation, and unjust enrichment to proceed.
The New York Attorney General's office has also investigated ghost networks. A study by the OAG found that 86% of mental health providers listed on health plans' networks were effectively ghosts. The U.S. Senate Finance Committee conducted a similar survey and found that, on average, 82% of directory listings were ineffective.
A separate lawsuit filed in October 2024 by federal employees with Anthem BCBS coverage alleged similar ghost network issues. That case was dismissed in March 2026 after the judge ruled that federal law governed the dispute, blocking state-law claims.
The ghost network lawsuit is the most significant controversy facing Carelon as of August 2026. The case could result in monetary damages and injunctive relief if the plaintiffs prevail. It also draws attention to broader industry issues with provider directory accuracy and mental health access.
No direct competitors found in the same category. This could be because Carelonoperates in a unique market segment or we're still building our competitor database.
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